Key result
Fresh frozen plasma as priming fluid and avoidance of antifibrinolytics during coronary artery bypass grafting in 2 patients with protein S deficiency resulted in no perioperative thrombotic complications.
Case Report (n=2)
Using fresh frozen plasma as priming fluid and avoiding antifibrinolytics may be a safe strategy to prevent thrombotic complications in patients with protein S deficiency undergoing CABG.
Should not yet change practice in protein S-deficient CABG; hypothesis-generating from 2 cases requiring prospective validation.
In this report, we review 2 cases of coronary revascularization in patients with a diagnosis of coronary artery disease and preoperative protein S deficiency, an established hypercoagulable condition. In an attempt to normalize protein S levels, fresh frozen plasma was used as the priming fluid for the cardiopulmonary bypass circuit before the initiation of extracorporeal circulation. On the basis of a low risk of bleeding and the theoretical risk of thrombosis, neither patient received intraoperative antifibrinolytic treatment nor did they develop perioperative thrombotic complications.
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Hsu et al. (2014) conducted a case report in Coronary artery disease and preoperative protein S deficiency (n=2). Fresh frozen plasma as priming fluid and avoidance of antifibrinolytic treatment was evaluated on Perioperative thrombotic complications. Fresh frozen plasma as priming fluid and avoidance of antifibrinolytics during coronary artery bypass grafting in 2 patients with protein S deficiency resulted in no perioperative thrombotic complications.
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