Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection
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 temperat...
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Mashhad University of Medical Sciences
2014-02-01
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doaj-4a2b299513f444e8b6e6963d02c1ee9e2020-11-25T04:01:00ZengMashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine 2345-24472322-57502014-02-01211371402196Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial ProtectionKambiz Alizadeh0Masoomeh Tabari1Behrooz Mottahedi2Delaram Sayadpour3Cardiac-Surgeon Department of Cardiac Surgery, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran2. Anesthesiologist,Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences,Mashhad, IranCardiac-Surgeon Department of Cardiac Surgery, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, IranPathologist, Department of Pathology, Jahad Daneshgahi of Mashhad, Mashhad, IranCold 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.http://jctm.mums.ac.ir/pdf_2196_4d2b4aa1b7ce0de8cc0fa48449b5a69c.htmlBypassCold Agglutininscardiac surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kambiz Alizadeh Masoomeh Tabari Behrooz Mottahedi Delaram Sayadpour |
spellingShingle |
Kambiz Alizadeh Masoomeh Tabari Behrooz Mottahedi Delaram Sayadpour Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection Journal of Cardio-Thoracic Medicine Bypass Cold Agglutinins cardiac surgery |
author_facet |
Kambiz Alizadeh Masoomeh Tabari Behrooz Mottahedi Delaram Sayadpour |
author_sort |
Kambiz Alizadeh |
title |
Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection |
title_short |
Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection |
title_full |
Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection |
title_fullStr |
Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection |
title_full_unstemmed |
Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection |
title_sort |
problems of cold agglutinins in cardiac surgery: how to manage cardiopulmonary bypass and myocardial protection |
publisher |
Mashhad University of Medical Sciences |
series |
Journal of Cardio-Thoracic Medicine |
issn |
2345-2447 2322-5750 |
publishDate |
2014-02-01 |
description |
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. |
topic |
Bypass Cold Agglutinins cardiac surgery |
url |
http://jctm.mums.ac.ir/pdf_2196_4d2b4aa1b7ce0de8cc0fa48449b5a69c.html |
work_keys_str_mv |
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