Antiphospholipid syndrome and valvular heart disease, a complex scenario of thrombotic events, a case report

Abstract

Background Antiphospholipid syndrome (APS) is a rare coagulation disorder associated with thrombotic events, myocardial infarction, and valvular heart disease. During valvular replacement surgery, the high risk of thrombosis combined with the operative risks in these specific groups of patients poses a challenge to the medical team. Case presentation We present a case of a female patient with APS and mixed aortic valve disease. During surgery, she suddenly developed complete cardiac arrest. Three months later, after she recovered, and while she was still on close follow up, a thrombotic event caused myocardial infarction. After prompt and precise treatment, the patient successfully recovered; one year after surgery patient is doing well. Conclusion Adequate surgical technique along with optimal anticoagulation strategies and long term follow up are of paramount importance to ensure an uneventful recovery. A multidisciplinary team is required to manage these complex scenarios and high-risk patients.

Management of cardiovascular surgery in patients with systemic lupus erythematosus including thromboembolism and multiple organ failure prevention: A retrospective observational study

“…It is well known that patients with APS have a higher risk of postoperative bleeding and thrombosis. [4,31,[34][35][36][37] Therefore, we decided to apply the APS severity classification to all preoperative cases and actively apply the APS management protocol to patients with APS severity of Grade III or higher. In addition, when CAPS is triggered by surgical stress, infection, sepsis, systemic inflammatory response syndrome, or inappropriate treatment, thrombosis and hemorrhage may occur in multiple organs simultaneously, resulting in a high mortality rate.…”

“…In addition, when CAPS is triggered by surgical stress, infection, sepsis, systemic inflammatory response syndrome, or inappropriate treatment, thrombosis and hemorrhage may occur in multiple organs simultaneously, resulting in a high mortality rate. [4,31,[34][35][36][37] At our hospital, we are currently applying an aggressive APS management protocol for patients with Grade III or higher according to the APS severity classification. For preoperative evaluation, 3 different serum tests are also used to measure antiphospholipid antibodies: the anticardiolipin enzyme-linked immunosorbent assay, LAC test, and anti-beta-2-glycoprotein I enzyme-linked immunosorbent assay.…”