The Korean Journal of Thoracic and Cardiovascular Surgery  2014;47(2):133-136

Normothermic Cardiac Surgery with Warm Blood Cardioplegia in Patient with Cold Agglutinins.

Sang Ho CHO 1 ; Dae Hyun KIM ; Young Tae KWAK

Affiliations

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Keywords

Cold agglutinins; Thoracic surgery; Cardiopulmonary bypass; Hemagglutination

Country

Republic of Korea

Language

English

Abstract

Cold agglutinins are predominately immunoglobulin M autoantibodies that react at cold temperatures with surface antigens on the red blood cell. This can lead to hemagglutination at low temperatures, followed by complement fixation and subsequent hemolysis on rewarming. Development of hemagglutination or hemolysis in patients with cold agglutinins is a risk of cardiac surgery under hypothermia. In addition, there is the potential for intracoronary hemagglutination with inadequate distribution of cardioplegic solutions, thrombosis, embolism, ischemia, or infarction. We report a patient with incidentally detected cold agglutinin who underwent normothermic cardiac surgery with warm blood cardioplegia.