Anesthetic management of a patient with polycythemia vera undergoing emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting: a case report.
10.4097/kjae.2015.68.6.608
- Author:
Hyeongwoo IM
1
;
Jeong Jin MIN
;
Jaeyoung YANG
;
Sangmin Maria LEE
;
Jong Hwan LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. prudence2@hanmail.net
- Publication Type:Case Report
- Keywords:
Acute normovolemic hemodilution;
Aortic dissection;
Coronary artery bypass grafting;
Hemostatic balance;
Polycythemia vera;
Thromboelastometry
- MeSH:
Aorta;
Cardiopulmonary Bypass;
Coronary Artery Bypass*;
Coronary Vessels*;
Emergencies*;
Erythrocytes;
Humans;
Polycythemia Vera*;
Polycythemia*;
Thrombelastography;
Thrombosis
- From:Korean Journal of Anesthesiology
2015;68(6):608-612
- CountryRepublic of Korea
- Language:English
-
Abstract:
Polycythemia vera is a chronic progressive myeloproliferative disease characterized by increased circulating red blood cells, and the hyperviscosity of the blood can lead to an increased risk of arterial thrombosis. In a previous survey regarding postoperative outcomes in polycythemia vera patients, an increased risk of both vascular occlusive and hemorrhagic complications have been reported. Aortic surgery involving cardiopulmonary bypass may be associated with the development of a coagulopathy, and as a result, the occurrence of thrombotic complications should be avoided after coronary anastomosis. Thus, optimizing the hemostatic balance is an important concern for anesthesiologists. However, only a few cases of anesthetic management in polycythemia vera patients undergoing concomitant aorta and coronary arterial bypass surgery have ever been reported. Here, we experience a polycythemia vera patient who underwent an emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting, and report this case with a review of the relevant literature.
