Document Detail

Management of a patient with a mechanical aortic valve and antibodies to both thrombin and factor V after repeat exposure to fibrin sealant.
MedLine Citation:
PMID:  10815789     Owner:  NLM     Status:  MEDLINE    
We describe a patient who developed a markedly prolonged PT, PTT, and thrombin time 13 days after repeat exposure to fibrin sealant during coronary artery bypass grafting and aortic valve replacement. Evaluation revealed an inhibitor to bovine thrombin that cross-reacted with human thrombin. In addition an inhibitor to human coagulation factor V was identified. Despite coagulation abnormalities there was no evidence of bleeding. Nevertheless, effective anticoagulation was required to minimize the thrombotic complications associated with the patient's prosthetic valve. We elected to take a conservative approach and not utilize pharmacologic anticoagulation until there was diminution in the effect of the acquired inhibitors. We report on our patient's course and review the available literature addressing the management of patients demonstrating inhibitors to blood coagulation factors after repeat exposure to fibrin sealants.
M S Zumberg; J M Waples; K J Kao; R Lottenberg
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of hematology     Volume:  64     ISSN:  0361-8609     ISO Abbreviation:  Am. J. Hematol.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-05-31     Completed Date:  2000-05-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7610369     Medline TA:  Am J Hematol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  59-63     Citation Subset:  IM    
Department of Medicine, University of Florida, Gainesville 32610, USA.
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MeSH Terms
Antibody Specificity
Cross Reactions
Factor V / immunology*
Fibrin Tissue Adhesive / adverse effects*,  immunology
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects*
Thrombin / immunology*
Reg. No./Substance:
0/Fibrin Tissue Adhesive; 9001-24-5/Factor V; EC

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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