Abstract

FERNANDEZ-TURIZO, Maria José et al. The addition of Tirofiban infusión to heparin for intraoperative heparin resistance associated with Marfan Syndrome. Rev. colomb. anestesiol. [online]. 2022, vol.50, n.4, e500.  Epub Nov 04, 2022. ISSN 0120-3347.  https://doi.org/10.5554/22562087.e1035.

Marfan syndrome classically presents with aortic root aneurysms. Aortic ectasia causes diverse blood flow alterations, influencing the behavior of coagulation factors and platelet activity. Heparin resistance has also been reported associated with Marfan Syndrome in a small number of patients, probably due to antithrombin III (ATIII) deficiency or various mutations. The ascending aorta and the aortic valve are replaced with prosthetic material during Bentall- de Bonno procedures. Resistance to anticoagulation during extracorporeal circulation, represents a significant challenge for both anesthesiologists and the surgical team. Resistance to heparin was observed in a patient with Marfan syndrome undergoing a Bentall procedure. ATIII concentrate was not available, and Activated Coagulation Time did not increase despite high doses of heparin. An alternate anticoagulation approach was used successfully.

Keywords : Cardiopulmonary bypass; Heparin, Resistance; Antithrombin III Deficiency; Anticoagulation; Platelet Aggregation Inhibitors; Anesthesiology.

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