Mitral Valve Replacement in A Case with A Cold Agglutinin

Şenol YAVUZ, Hüsnü SEZER, Muammer AKAR, Sait ATALAY, Ahmet ÖCAL, Ahmet

Bursa Yüksek İhtisas Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Bursa

The presence of cold agglutinins leads to serious problems for those involved with cardi ac surgery. Cold agglutinins cause aggregation and hemolysis of red blood celcs when acti vated by low tcmperatures. Mitral valve replacement was pcrformed in a patient with a cold agglutinin. Surgical procedure was performed undcr total cardiopulmonary bypass, moderate systemic hypothermia (30°C) and aortic cross-clamping. No advorse effects of cold agglutinin appearcd during peri- and postoperativc course. Because of the use of hy pothermic cardiopulmonary procedures, many cardiac surgical units routinely test for agg lutinins and determine the temperatures at which they become activated.

In this article, technical considerations for open-heart surgery in patients with cold agg lutinin are described.

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