Antiphospholipid antibodies lead to increased risk in cardiovascular surgery.

Abstract:

BACKGROUND:Antiphospholipid (APL) antibodies are a heterogenous group of antibodies that have been associated with an increase in bleeding complications and a marked increase in thrombotic events, both of which result in significant patient morbidity and mortality. PATIENTS AND METHODS:A retrospective analysis of patients identified to be positive for APL via a university thrombosis registry who had cardiovascular surgery between 1989 and 1994. RESULTS:Seventy-one patients positive for APL antibodies were identified. Of those patients, 19 had cardiovascular surgical procedures (11 women and 8 men, mean age 58.4 years, range 38 to 78). A total of 48 cardiovascular surgical procedures (mean 2.5 procedures/patient) were performed in the 19 patients. These procedures included 13 lower-extremity reconstructions, 11 upper-extremity reconstructions/fistulas, 8 cardiac valve replacements, 5 coronary artery bypass procedures, 5 major amputations, 4 infrarenal aortic reconstructions, and 2 carotid endarterectomies. Sixteen of the 19 patients (84.2%) suffered major postoperative complications. These included 16 thrombosed grafts, 5 strokes, 5 major bleeding events, 2 pulmonary emboli, and 2 myocardial infarctions. Ultimately, 12 of the 19 patients (63.2%) died of complications related to surgery. CONCLUSIONS:This series of patients confirms that patients with circulating APL antibodies are prone to excessive postoperative morbidity and mortality after cardiovascular surgical procedures. The presence of APL antibodies may be a maker of increased risk of complications after cardiovascular surgery.

journal_name

Am J Surg

authors

Ciocca RG,Choi J,Graham AM

doi

10.1016/s0002-9610(99)80285-2

subject

Has Abstract

pub_date

1995-08-01 00:00:00

pages

198-200

issue

2

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(99)80285-2

journal_volume

170

pub_type

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