Antifosfolipid Sendromlu Bir Hastada Başarılı Mitral Kapak Replasmanı

Abstract

Elli bir yaşında mitral yetmezlik tanısı ile cerrahi tedavi için yatırılan bir hastayı sunduk. Dört yıl önce primer antifosfolipid tanısı almış ve trombositopeni hikayesi mevcut. Postoperatif titiz antikoagülan tedavi ile mitral kapak başarılı bir şekilde replase edildi ve postoperatif dönem olaysız geçti. Antifosfolipid sendromlu hastalarda kardiyak cerrahide yüksek mortalite ve morbidite oranları bildirilmiştir. Postoperatif dönemde hemen antikoagülan tedavinin başlanması trombozun önlenmesi açısından çok önemlidir.

Keywords

• Antifosfolipid sendromu,mitral kapak,trombositopeni

Successful Replacement of Mitral Valve in a Patient with Antiphospholipid Syndrome

Abstract

We report a 51-year-old patient who was diagnosed with mitral insufficiency and was admitted to our hospital for surgical treatment. The patient was diagnosed with primary antiphospholipid syndrome (PAPS) before 4 years and had a history of thrombocytopenia. Mitral valve replacement was successfully performed with postoperative strict anticoagulant therapy, and the postoperative course was uneventful. Cardiac surgery in APS patients has been associated with high morbidity and mortality. Therefore, it is very important to initiate anticoagulant therapy immediately after the operation to prevent thrombosis.

Keywords

• Antiphospholipid syndrome,mitral valve,thrombocytopenia

References

1. 1. Vila P, Hernandez M, Lopez-Fernandez M. Prevalance, follow-up and clinical significance of the anticardiolipin antibodies in normal subjects. Thromb Haemost 1994;72:209-13.
2. 2. Turiel M, Muzzupappa S, Gottardi B. Evaluation of cardiac abnormalities and embolic sources in primary antiphospholipid syndrome by transesophageal achocardiography. Lupus 2000;9:406-12.
3. 3. Kaplan SD, Chartash EK, Pizzarello RA. Cardiac manifestationsof the antiphospholipid syndrome. Am Heart J 1992;124:1331-8.
4. 4. Matsuyama K, Ueda Y, Ogino H. Aortic valve replacement for aortic regurgitation in a patient with primary antiphospholipid syndrome. Am Heart J 1999;63:973-8.
5. 5. Kato Y, Isobe F, Sasaki Y. Mitral insufficiency associated with primary antiphospholipid syndrome and chronic renal failure. Jpn J Thorac Cardiovasc Surg 2001;49:171-4.
6. 6. Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306.
7. 7. Araki Y, Tajima K, Shimomura T. A case report on mitral valve replacement associated with antiphospholipid syndrome in systemic lupus erythematosus. Kyobu Geka 1997;50:480-2.
8. 8. Massoudy P, Cetin SM, Thielmann M, Kienbaum P, Piotrowski JA, Marggraf G, et al. Antiphospholipid syndrome in cardiac surgery-an underestimated coagulation disorder? Eur J Cardiothorac Surg 2005;28:133-7.

9. 9. Bardakçı H. Antifosfolipid sendrom ve Kalp Cerrahisi. TJIC 2007;11:77-82.
10. 10. Engelberger L, Streich M, Tevaearai H, Carrel TP. Different anticoagulation strategies in off-pump coronary artery bypass operations: a European survey. Interact Cardiovasc Thorac Surg 2008;7:378-82.
11. 11. Ruiz-Irastora G, Khamashta MA, Hunt BJ, Escudero A, Cuadrado MJ, Hughes GR. Bleeding and recurrent thrombosis in definite antiphospholipid syndrome. Analysis of a series of 66 patients treated with oral anticoagulation to a target international normalized ratio of 3.5. Arch Intern Med 2002;162:1164-9.