TY - JOUR
T1 - Coronary artery bypass grafting in a patient with protein S deficiency
T2 - Perioperative implications
AU - Balan, Baskaran
AU - Chengode, Suresh
AU - Al Sabti, Hilal
AU - Rao, Ram Narayan
PY - 2014
Y1 - 2014
N2 - Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation therapy. The risk of developing thrombotic complications is heightened in the perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Heparin resistance is very rare in these patients, especially when antithrombin levels are near normal. Management of CPB in this scenario is quite challenging. We report the perioperative management, particularly the CPB management, of a patient with type I PS deficiency and incidentally detected heparin resistance, who underwent coronary artery bypass grafting with CPB.
AB - Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation therapy. The risk of developing thrombotic complications is heightened in the perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Heparin resistance is very rare in these patients, especially when antithrombin levels are near normal. Management of CPB in this scenario is quite challenging. We report the perioperative management, particularly the CPB management, of a patient with type I PS deficiency and incidentally detected heparin resistance, who underwent coronary artery bypass grafting with CPB.
KW - Cardiopulmonary bypass
KW - Coronary artery bypass grafting
KW - Heparin resistance
KW - Hypercoagulable states
KW - Protein S deficiency
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U2 - 10.4103/0971-9784.135875
DO - 10.4103/0971-9784.135875
M3 - Article
C2 - 24994735
AN - SCOPUS:84905040194
SN - 0971-9784
VL - 17
SP - 232
EP - 236
JO - Annals of Cardiac Anaesthesia
JF - Annals of Cardiac Anaesthesia
IS - 3
ER -