Complete antithrombin replacement for anticoagulation for cardiopulmonary bypass to repair severe infective mitral valve endocarditis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

We present a case of a 26-year-old patient with severe infective endocarditis complicated with cerebral septic emboli that required essentially complete replacement of his circulating antithrombin activity to achieve an activated coagulation time near 480s. The need for this degree of antithrombin administration may have been secondary to ongoing systemic inflammation and consequent thrombin generation despite blood culture results demonstrating no bacteremia. In sum, ongoing loss of endogenous antithrombin activity secondary to inflammation and the need for more than 80% normal activity to conduct safe cardiopulmonary bypass may require extraordinary administration of exogenous antithrombin in similar settings.

Original languageEnglish (US)
Pages (from-to)123-125
Number of pages3
JournalBlood Coagulation and Fibrinolysis
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2018

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Antithrombins
Endocarditis
Cardiopulmonary Bypass
Mitral Valve
Inflammation
Intracranial Embolism
Bacteremia
Thrombin

Keywords

  • Activated clotting time
  • Antithrombin
  • Cardiopulmonary bypass
  • Endocarditis

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "Complete antithrombin replacement for anticoagulation for cardiopulmonary bypass to repair severe infective mitral valve endocarditis",
abstract = "We present a case of a 26-year-old patient with severe infective endocarditis complicated with cerebral septic emboli that required essentially complete replacement of his circulating antithrombin activity to achieve an activated coagulation time near 480s. The need for this degree of antithrombin administration may have been secondary to ongoing systemic inflammation and consequent thrombin generation despite blood culture results demonstrating no bacteremia. In sum, ongoing loss of endogenous antithrombin activity secondary to inflammation and the need for more than 80{\%} normal activity to conduct safe cardiopulmonary bypass may require extraordinary administration of exogenous antithrombin in similar settings.",
keywords = "Activated clotting time, Antithrombin, Cardiopulmonary bypass, Endocarditis",
author = "Soojie Yu and Khalpey, {Zain I} and Wong, {Raymond K} and Thanh Huynh and Nielsen, {Vance G}",
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T1 - Complete antithrombin replacement for anticoagulation for cardiopulmonary bypass to repair severe infective mitral valve endocarditis

AU - Yu, Soojie

AU - Khalpey, Zain I

AU - Wong, Raymond K

AU - Huynh, Thanh

AU - Nielsen, Vance G

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N2 - We present a case of a 26-year-old patient with severe infective endocarditis complicated with cerebral septic emboli that required essentially complete replacement of his circulating antithrombin activity to achieve an activated coagulation time near 480s. The need for this degree of antithrombin administration may have been secondary to ongoing systemic inflammation and consequent thrombin generation despite blood culture results demonstrating no bacteremia. In sum, ongoing loss of endogenous antithrombin activity secondary to inflammation and the need for more than 80% normal activity to conduct safe cardiopulmonary bypass may require extraordinary administration of exogenous antithrombin in similar settings.

AB - We present a case of a 26-year-old patient with severe infective endocarditis complicated with cerebral septic emboli that required essentially complete replacement of his circulating antithrombin activity to achieve an activated coagulation time near 480s. The need for this degree of antithrombin administration may have been secondary to ongoing systemic inflammation and consequent thrombin generation despite blood culture results demonstrating no bacteremia. In sum, ongoing loss of endogenous antithrombin activity secondary to inflammation and the need for more than 80% normal activity to conduct safe cardiopulmonary bypass may require extraordinary administration of exogenous antithrombin in similar settings.

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