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Anticoagulation management during cardiopulmonary bypass in patients with antiphospholipid syndrome

  • Tatsuya Seki
  • Yasushige Shingu
  • Hiroshi Sugiki
  • Satoru Wakasa
  • Hiroki Katoh
  • Tomonori Ooka
  • Tsuyoshi Tachibana
  • Suguru Kubota
  • Yoshiro Matsui
Case Report Cardiopulmonary Bypass

Abstract

Antiphospholipid syndrome (APS) is a complex autoimmune disease often related to systemic lupus erythematosus. Although adequate anticoagulation is important for APS patients during cardiopulmonary bypass, clotting tests can be potentially misleading due to antiphospholipid antibodies. We performed cardiac surgery safely in two APS patients under anticoagulation monitoring determined using preoperative heparin titration. We performed heparin titration for activated clotting time to determine the appropriate heparin concentration during cardiac surgery. We changed the targeted heparin concentration considering each patient’s thrombotic risks: 3 U/ml of heparin for a normal-risk APS patient and 5 U/ml for a high-risk APS patient with a history of antiphospholipid-antibody-associated thrombocytopenia. A higher targeted heparin concentration might be necessary for patients with high thrombotic risks.

Keywords

Antiphospholipid syndrome Cardiopulmonary bypass Anticoagulation 

Notes

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

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Copyright information

© The Japanese Society for Artificial Organs 2018

Authors and Affiliations

  • Tatsuya Seki
    • 1
  • Yasushige Shingu
    • 1
  • Hiroshi Sugiki
    • 2
  • Satoru Wakasa
    • 1
  • Hiroki Katoh
    • 3
  • Tomonori Ooka
    • 1
  • Tsuyoshi Tachibana
    • 1
  • Suguru Kubota
    • 1
  • Yoshiro Matsui
    • 1
  1. 1.Department of Cardiovascular and Thoracic SurgeryHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Department of Cardiothoracic SurgeryAsahikawa City HospitalAsahikawaJapan
  3. 3.Emergency and Critical Care CenterHokkaido University HospitalSapporoJapan

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