tailieunhanh - Báo cáo y học: "Antiphospholipid syndrome; its implication in cardiovascular diseases: a review"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Antiphospholipid syndrome; its implication in cardiovascular diseases: a review. | Koniari et al. Journal of Cardiothoracic Surgery 2010 5 101 http content 5 1 101 REVIEW JOTS JOURNAL OF CARDIOTHORACIC SURGERY Open Access Antiphospholipid syndrome its implication in cardiovascular diseases a review 1 2 1 3 4 Ioanna Koniari Stavros N Siminelakis Nikolaos G Baikoussis Georgios Papadopoulos John Goudevenos Efstratios Apostolakis 1 Abstract Antiphospholipid syndrome APLS is a rare syndrome mainly characterized by several hyper-coagulable complications and therefore implicated in the operated cardiac surgery patient. APLS comprises clinical features such as arterial or venous thromboses valve disease coronary artery disease intracardiac thrombus formation pulmonary hypertension and dilated cardiomyopathy. The most commonly affected valve is the mitral followed by the aortic and tricuspid valve. For APLS diagnosis essential is the detection of so-called antiphospholipid antibodies aPL as anticardiolipin antibodies aCL or lupus anticoagulant LA . Minor alterations in the anticoagulation infection and surgical stress may trigger widespread thrombosis. The incidence of thrombosis is highest during the following perioperative periods preoperatively during the withdrawal of warfarin postoperatively during the period of hypercoagulability despite warfarin or heparin therapy or postoperatively before adequate anticoagulation achievement. Cardiac valvular pathology includes irregular thickening of the valve leaflets due to deposition of immune complexes that may lead to vegetations and valve dysfunction a significant risk factor for stroke. Patients with APLS are at increased risk for thrombosis and adequate anticoagulation is of vital importance during cardiopulmonary bypass CPB . A successful outcome requires multidisciplinary management in order to prevent thrombotic or bleeding complications and to manage perioperative anticoagulation. More work and reporting on anticoagulation management and adjuvant therapy in patients with