Cardiopulmonary Bypass in a Patient with Factor XII Deficiency

The performance of cardiopulmonary bypass (CPB) in the factor XII-deficient patient is challenging in that the normal method for monitoring anticoagulation is ineffective as a result of an impaired contact activation system. We report the case of a factor XII-deficient patient who underwent surgical...

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Bibliographic Details
Published in:	The Journal of extra-corporeal technology Vol. 46; no. 3; pp. 251 - 253
Main Authors:	Cronbaugh, Robert D, Fuller, Lori A, Miller, Scott D M, Richenbacher, Wayne E
Format:	Journal Article
Language:	English
Published:	United States American Society of ExtraCorporeal Technology 01-09-2014
Subjects:	Aged Anticoagulants - therapeutic use Cardiopulmonary Bypass - methods Case Reports Coronary Artery Disease - surgery Factor XII Deficiency - physiopathology Health technology assessment Humans Male
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Summary:	The performance of cardiopulmonary bypass (CPB) in the factor XII-deficient patient is challenging in that the normal method for monitoring anticoagulation is ineffective as a result of an impaired contact activation system. We report the case of a factor XII-deficient patient who underwent surgical revascularization on CPB. His factor XII level was replenished with fresh-frozen plasma immediately before surgery. This management strategy lowered the baseline activated clotting time (ACT) to near normal, providing a meaningful ACT value for CPB. Factor XII is also a key component in the fibrinolytic system and its deficiency is associated with increased thrombosis. Because the factor XII level quickly returns to baseline postoperatively, perioperative care must include strategies to avoid postoperative thromboembolic events.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 The senior author has stated that the authors have reported no material, financial, or other relationship with any healthcare-related business or other entity whose products or services are discussed in this paper.
ISSN:	0022-1058 2969-8960
DOI:	10.1051/ject/201446251