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Ann Thorac Surg 2007;84:1390-1391
© 2007 The Society of Thoracic Surgeons

Case Reports

Aortic Valve Replacement in a Patient With the Prothrombin 20210A Mutation

Samuel M. Galvagno, Jr, DO, Teresa M. Bean, MD, Michael McAdams, CCP, Michael N. D’Ambra, MD*

Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiac Surgery, Brigham and Woman’s Hospital, Boston, Massachusetts

Accepted for publication May 14, 2007.

* Address correspondence to Dr D’Ambra, Brigham and Women’s Hospital, Department of Anesthesiology, Perioperative, and Pain Medicine, Division of Cardiac Anesthesia, 75 Francis St, Boston, MA 02115 (Email: mdambra{at}partners.org).

Patients presenting for cardiac surgery with hypercoagulable states pose a challenge. Although preoperative functional and genetic screening for hypercoagulable disorders may provide patholophysiologic information, it is difficult to make preoperative hematologic management plans in the absence of consensus guidelines, prospective studies, or case reports. We document the first case of prothrombin 20210A mutation in a patient undergoing elective aortic valve replacement. Peri-procedural bridging with heparin and avoidance of antifibrinolytic agents represent salient features of our successful perioperative management.






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Copyright © 2007 by The Society of Thoracic Surgeons.