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BJA Advance Access originally published online on March 5, 2004
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British Journal of Anaesthesia, 2004, Vol. 92, No. 5 748-754
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Acute postoperative biventricular failure associated with antiphospholipid antibody syndrome

R. I. P. Dornan

Department of Anaesthesia, Royal Infirmary of Edinburgh, Little France, Old Dalkeith Road, Edinburgh EH16 4SU, UKE-mail: dripdo@doctors.org.uk

Antiphospholipid syndrome is probably the most common acquired hypercoagulable state, but information on perioperative management is sparse. Minor alterations in anticoagulant therapy, infection, or a surgical insult may trigger widespread thrombosis. The perioperative course of a 31-yr-old woman with primary anticardiolipin antiphospholipid antibody syndrome requiring a mitral valve replacement is described. Postoperatively, she developed acute global biventricular failure requiring extracorporeal membrane oxygenation support and plasmapheresis. The management of anticoagulation and cardiac surgery in this condition is reviewed.

Br J Anaesth 2004; 92: 748–54


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