Aortic Valve Replacement to a Patient with High Titer of Cold Agglutinin

作者：Kansaku Rei^*; Kuwaki Kenji; Amano Atsushi; Inaba Hirotaka; Tambara Keiichi; Yamamoto Taira; Sakakibara Naoki

来源：Annals of Thoracic and Cardiovascular Surgery, 2012, 18(3): 259-261.

DOI：10.5761/atcs.cr.11.01753

• aortic valve
• ascending aorta
• cardiopulmonary bypass
• cardioplegia
• cold agglutinin

A 60-year-old man was admitted to our hospital because of aortic stenosis with a peak pressure gradient of 61 mmHg, moderate aortic regurgitation, and a dilatation of the ascending aorta of 50 mm in diameter, which had grown 5 mm in 2 years. Because of severe aortic stenosis with a bicuspid valve and fast progression of the ascending aorta in size, replacements of both the aortic valve and the ascending aorta were planned. %26lt;br%26gt;He had experienced severe acute renal failure with hemolysis because of cold agglutinin one year before the operation. The hemoglobin had decreased to 4.3 g/dL during hemolytic attack. His titer of cold agglutinin was extremely high. The titer of cold agglutinin has kept above than 1:131072 at 4 degree Celsius. It once increased to 1:524288. %26lt;br%26gt;Both the replacement of the aortic valve and the ascending aorta under normothermic cardiopulmonary bypass using intermittent warm blood cardioplegia were completed unevent-fully. He was discharged from the hospital on postoperative day 11.

• 出版日期2012-6