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Intracardiac Thrombosis and Acute Right Ventricular Failure Following Complex Reoperative Cardiac Surgery With Aprotinin and Deep Hypothermic Circulatory Arrest

Mount Sinai School of Medicine, New York, New York, marc.stone{at}mountsinai.org

Scott H. Silverman, MD

Mount Sinai School of Medicine, New York, New York

Koichi Nomoto, MD

Mount Sinai School of Medicine, New York, New York

Although coagulopathy and bleeding are common in the setting of cardiac surgery, a growing number of case reports in the literature suggest that hypercoagulability may also result in significant morbidity and mortality. We present a case of apparent hypercoagulability with formation of thrombus in the cardiac chambers following reoperative cardiac surgery using cardiopulmonary bypass, aprotinin, and deep hypothermic arrest. A review of those hypercoagulable disorders with reported impact on cardiac surgery and a discussion follow the case presentation.

Key Words: antifibrinolytic • aprotinin • deep hypothermic circulatory arrest • hypercoagulability • surgery • cardiac • thrombophilia • thrombosis • cardiovascular

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