The addition of Tirofiban infusion to heparin for intraoperative heparin resistance associated with Marfan Syndrome

Maria José  Fernandez-Turizo; David  Benavidez-Zora; Augusto Enrique  Anaya-Hoyos; Sebastian  Portillo-Gómez; Hernán Darío  Castro-Arias

doi:10.5554/22562087.e1035

Maria José Fernandez-Turizo Clínica El Rosario. Medellín, Colombia.
David Benavidez-Zora Clínica Medellín Grupo Quironsalud. Medellín, Colombia.
Augusto Enrique Anaya-Hoyos Clínica las Américas. Medellín, Colombia.
Sebastian Portillo-Gómez Clínica Medellín Grupo Quironsalud. Medellín, Colombia.
Hernán Darío Castro-Arias a. Clínica Medellín Grupo Quironsalud. Medellín, Colombia. b. Cardiovascular Anesthesiology Program, Universidad CES. Medellín, Colombia.

DOI: https://doi.org/10.5554/22562087.e1035

Keywords: Cardiopulmonary bypass, Heparin, Resistance, Antithrombin III Deficiency, Anticoagulation, Platelet Aggregation Inhibitors, Anesthesiology

Abstract References How to Cite Downloads

Abstract

Marfan syndrome classically presents with aortic root aneurysms. Aortic ectasia causes diverse blood flow alterations, influencing the behavior of coagulation factors and platelet activity. Heparin resistance has also been reported associated with Marfan Syndrome in a small number of patients, probably due to antithrombin III (ATIII) deficiency or various mutations. The ascending aorta and the aortic valve are replaced with prosthetic material during Bentall- de Bonno procedures. Resistance to anticoagulation during extracorporeal circulation, represents a significant challenge for both anesthesiologists and the surgical team. Resistance to heparin was observed in a patient with Marfan syndrome undergoing a Bentall procedure. ATIII concentrate was not available, and ACT did not increase despite high doses of heparin. An alternate anticoagulation approach was used successfully.

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How to Cite

1.

Fernandez-Turizo MJ, Benavidez-Zora D, Anaya-Hoyos AE, Portillo-Gómez S, Castro-Arias HD. The addition of Tirofiban infusion to heparin for intraoperative heparin resistance associated with Marfan Syndrome. Colomb. J. Anesthesiol. [Internet]. 2022 Mar. 16 [cited 2023 Dec. 5];50(4). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1035