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Alizadeh, Kambiz, Tabari, Masoomeh, Mottahedi, Behrooz, Sayadpour, Delaram. (1392). Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection. , 2(1), 137-140. doi: 10.22038/jctm.2014.2196
Kambiz Alizadeh; Masoomeh Tabari; Behrooz Mottahedi; Delaram Sayadpour. "Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection". , 2, 1, 1392, 137-140. doi: 10.22038/jctm.2014.2196
Alizadeh, Kambiz, Tabari, Masoomeh, Mottahedi, Behrooz, Sayadpour, Delaram. (1392). 'Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection', , 2(1), pp. 137-140. doi: 10.22038/jctm.2014.2196
Alizadeh, Kambiz, Tabari, Masoomeh, Mottahedi, Behrooz, Sayadpour, Delaram. Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection. , 1392; 2(1): 137-140. doi: 10.22038/jctm.2014.2196

Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection

Journal of Cardio-Thoracic Medicine
مقاله 8، دوره 2، شماره 1، اردیبهشت 2014، صفحه 137-140    اصل مقاله (274.14 K)
نوع مقاله: Case Report
شناسه دیجیتال (DOI): 10.22038/jctm.2014.2196
نویسندگان
Kambiz Alizadeh1؛ Masoomeh Tabari* 2؛ Behrooz Mottahedi1؛ Delaram Sayadpour3
1Cardiac-Surgeon Department of Cardiac Surgery, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Anesthesiologist,Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences,Mashhad, Iran
3Pathologist, Department of Pathology, Jahad Daneshgahi of Mashhad, Mashhad, Iran
چکیده
Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB). Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies) that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M autoantibodies to red blood cells, which activateat varying levels of hypothermia, can cause catastrophic hemagglutination,microvascular thrombosis, or hemolysis. Management of anesthesia in these patients includes strict maintenance of normothermia. Patients scheduled for the surgery requiring cardiopulmonary bypass present significant challenges. Use of systemic hypothermia may be contraindicated, and cold cardioplegia solutions may precipitate intracoronary hemagglutination with consequent thrombosis, ischemia, or infarction. Management of CPB andmyocardial protection requires individualized planning. We describea case of MV repair and CABG in a patient with high titercold agglutinins and high thermal amplitude for antibody activation.Normothermic CPB and continuous warm blood cardioplegia weresuccessfully used.
کلیدواژه‌ها
Bypass؛ Cold Agglutinins؛ Cardiac Surgery
آمار
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