Cold Agglutinins in a Patient Undergoing Aortic Arch Repair: Temperature Control and Perfusion Strategy

Abstract

(thiamazole, 30 mg, and potassium iodide, 50 mg daily) in combination with a beta-blocker (bisoprolol, 2.5 mg daily). The physician paid the utmost attention to prevent agranulocytosis, which can be induced by thiamazole, and the patient's dose was within the recommended range (30-40 mg daily if serum FT4 is 2-3 times the upper limit of the normal). 1,2,6 Coronary artery bypass grafting was rescheduled 3 weeks after the commencement of the hyperthyroidism treatment because serum FT4 and FT3 were still abnormally high (2.32 ng/dL and 6.61 pg/mL, respectively; see Fig 1) as a result of his angina pectoris becoming more unstable with the frequent chest discomfort. The patient received midazolam, 3 mg, intravenously (IV) and fentanyl, 200 mg, IV upon induction of anesthesia and had a target-controlled infusion of propofol at 1 to 2 mg/mL and remifentanil at 0.1 to 0.5 mg/kg/min for maintenance. Multiple