Antiphospholipid syndrome with chronic thromboembolic pulmonary hypertension and coronary artery disease: a case report.
Adult
Anticoagulants
Antiphospholipid Syndrome
/ complications
Coronary Angiography
/ adverse effects
Coronary Artery Bypass
/ adverse effects
Coronary Artery Disease
/ complications
Endarterectomy
Female
Humans
Hypertension, Pulmonary
/ complications
Hypoxia
Perioperative Period
Pulmonary Artery
/ surgery
Pulmonary Embolism
/ complications
Treatment Outcome
Antiphospholipid syndrome
Chronic thromboembolic pulmonary hypertension
Coronary artery bypass grafting
Pulmonary endarterectomy
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
24 Aug 2020
24 Aug 2020
Historique:
received:
06
05
2020
accepted:
22
07
2020
entrez:
26
8
2020
pubmed:
26
8
2020
medline:
13
1
2021
Statut:
epublish
Résumé
Antiphospholipid syndrome (APS) is characterized by the production of antiphospholipid antibodies associated with recurrent vascular thrombosis. There have been few reports of combination of chronic thromboembolic pulmonary hypertension (CTEPH) and coronary artery disease in APS, therefore, it is unclear about appropriate treatment strategy. The patient was a 39 year-old-lady who had been suffering from hypoxia without chest pain. Transthoracic echocardiography showed severe pulmonary hypertension and mild hypokinesis of left ventricular anteroseptal wall. Simultaneously with the diagnosis of CTEPH, coronary angiography revealed severe stenosis of the left anterior descending artery. She underwent pulmonary endarterectomy (PEA) concomitant with coronary artery bypass grafting (CABG) successfully. CABG could be performed concomitantly during rewarming. During perioperative period, she was free from any thromboembolic and bleeding events despite receiving anticoagulant and antiplatelet therapies. PEA concomitant with coronary artery bypass grafting was feasible for APS patients complicated with CTEPH and coronary artery disease. APS patients with the presence of left ventricular dysfunction should be evaluated for coronary artery disease.
Sections du résumé
BACKGROUND
BACKGROUND
Antiphospholipid syndrome (APS) is characterized by the production of antiphospholipid antibodies associated with recurrent vascular thrombosis. There have been few reports of combination of chronic thromboembolic pulmonary hypertension (CTEPH) and coronary artery disease in APS, therefore, it is unclear about appropriate treatment strategy.
CASE PRESENTATION
METHODS
The patient was a 39 year-old-lady who had been suffering from hypoxia without chest pain. Transthoracic echocardiography showed severe pulmonary hypertension and mild hypokinesis of left ventricular anteroseptal wall. Simultaneously with the diagnosis of CTEPH, coronary angiography revealed severe stenosis of the left anterior descending artery. She underwent pulmonary endarterectomy (PEA) concomitant with coronary artery bypass grafting (CABG) successfully. CABG could be performed concomitantly during rewarming. During perioperative period, she was free from any thromboembolic and bleeding events despite receiving anticoagulant and antiplatelet therapies.
CONCLUSIONS
CONCLUSIONS
PEA concomitant with coronary artery bypass grafting was feasible for APS patients complicated with CTEPH and coronary artery disease. APS patients with the presence of left ventricular dysfunction should be evaluated for coronary artery disease.
Identifiants
pubmed: 32838812
doi: 10.1186/s13019-020-01254-4
pii: 10.1186/s13019-020-01254-4
pmc: PMC7446200
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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