Surgical treatment of atrial septal defect in a patient with familial antithrombin-III deficiency.

Abstract

PURPOSE:

A 41-year-old woman with familial antithrombin-III deficiency was admitted to our hospital for patch closure of an atrial septal defect. Antithrombin-III activity was 43% and its antigen level was 12.2 mg/dl, was diagnosed so type I antithrombin-III deficiency was diagnosed.

METHODS:

A dose of 2500 U of antithrombin-III concentrate was administered at 1 day before surgery, 1 hour before surgery, and 1 day after surgery. Heparinazation was performed at 200 IU/kg and the activated clotting time increased from a baseline of 140s to 622s. After establishing cardiopulmonary bypass and cardioplegic arrest, closure of the septal defect was done with a pericardial patch.

RESULTS:

The activated clotting time was maintained at more than 400s during cardiopulmonary bypass. There were no intraoperative complications and the postoperative course was uneventful.

CONCLUSION:

In patients with familial antithrombin-III deficiency, administration of antithrombin-III concentrate is effective when cardiopulmonary bypass is required.

• Authors: Tsutomu Hattori, Mitsumasa Hata, Akira Sezai, Shinji Wakui, Motomi Shiono
• Journal: Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia (Ann Thorac Cardiovasc Surg) Vol. 19 Issue 4 Pg. 323-5 ( 2013) ISSN: 2186-1005 [Electronic] Japan
• PMID: 23232305 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antithrombins
• Antithrombin III

Topics

• Adult
• Antithrombin III (administration & dosage)
• Antithrombin III Deficiency (blood, complications, diagnosis, drug therapy)
• Antithrombins (administration & dosage)
• Blood Coagulation (drug effects)
• Cardiac Surgical Procedures
• Cardiopulmonary Bypass
• Female
• Heart Arrest, Induced
• Heart Septal Defects, Atrial (complications, diagnosis, surgery)
• Humans
• Pericardium (transplantation)
• Treatment Outcome