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Heme oxygenase derived carbon monoxide and iron mediated plasmatic hypercoagulability in a patient with calcific mitral valve disease

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Abstract

We present a case of a patient with calcific mitral valve stenosis and plasmatic hypercoagulability. Using thrombelastography, the patient was determined to have an abnormally large velocity of plasma thrombus growth and strength with reduced vulnerability to lysis. Critically, increased carboxyhemoglobin concentration (2.4 %) was present, likely secondary to hemolysis from mitral stenosis and engagement of systemic heme oxygenase. It was determined that the patient’s plasmatic hypercoagulability was in part due to carboxyhemefibrinogen formation and iron-enhancement of coagulation via two thrombelastographic methods. In conclusion, future investigation of the involvement of both carbon monoxide and iron mediated hypercoagulability in the setting of stenotic valve disease is warranted.

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Acknowledgments

This investigation was supported by the Department of Anesthesiology.

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Authors and Affiliations

  1. Department of Surgery, The University of Arizona College of Medicine, Tucson, AZ, 85724-5114, USA

    Jess L. Thompson III

  2. Department of Anesthesiology, The University of Arizona College of Medicine, P.O. Box 245114, 1501 North Campbell Avenue, Tucson, AZ, 85724-5114, USA

    Vance G. Nielsen, Allison R. Castro & Andrew Chen

Authors
  1. Jess L. Thompson III
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  2. Vance G. Nielsen
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  3. Allison R. Castro
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  4. Andrew Chen
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Correspondence to Vance G. Nielsen.

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Thompson, J.L., Nielsen, V.G., Castro, A.R. et al. Heme oxygenase derived carbon monoxide and iron mediated plasmatic hypercoagulability in a patient with calcific mitral valve disease. J Thromb Thrombolysis 39, 532–535 (2015). https://doi.org/10.1007/s11239-014-1134-x

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  • DOI: https://doi.org/10.1007/s11239-014-1134-x

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