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BJA Advance Access published online on March 5, 2004

British Journal of Anaesthesia, doi:10.1093/bja/aeh116
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted January 6, 2004

Case Reports

Acute postoperative biventricular failure associated with antiphospholipid antibody syndrome

R. I. P. Dornan 1*

1 Department of Anaesthesia, Royal Infirmary of Edinburgh, Little France, Old Dalkeith Road, Edinburgh EH16 4SU, UK

* To whom correspondence should be addressed. E-mail: dripdo{at}doctors.org.uk.


   Abstract

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.

Keywords: Keywords: anaesthesia, cardiac; blood, clotting; complications, antiphospholipid syndrome


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