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Hypothermic circulatory arrest for aortic dissection with cryoglobulinemia
Author(s) -
Yamazaki Kazuhiro,
Minatoya Kenji,
Sakamoto Kazuhisa,
Kitagori Koji,
Okuda Masanori,
Murakami Kosaku
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14908
Subject(s) - medicine , cardiopulmonary bypass , aortic dissection , cryoglobulinemia , circulatory system , ascending aorta , deep hypothermic circulatory arrest , hypothermia , perioperative , aortic aneurysm , cerebral perfusion pressure , perfusion , cardiac surgery , cryoglobulin , aneurysm , cardiology , anesthesia , surgery , aorta , hepatitis c virus , virus , virology
Cryoglobulinemia is a cold‐reactive autoimmune disease. A 64‐year‐old man with active cryoglobulinemia presented Stanford type A acute aortic dissection. He had been treated with immunosuppressive drugs and plasma exchange (PE) at our hospital; subsequently, qualitative analysis of cryoglobulin (CG) was negative. He underwent emergency ascending aorta replacement using cardiopulmonary bypass (CPB) under deep hypothermia circulatory arrest with selective cerebral perfusion. The total CPB time, aortic cross‐clamp time, and selective cerebral perfusion time were 255, 153, 56 minutes, respectively, and the minimal nasopharyngeal temperature was 17.3°C. Our patient had no significant perioperative complications. Hence, if PE is performed appropriately and CG is negative, patients with cryoglobulinemia who exhibit severe preoperative symptoms can safely undergo surgery with deep hypothermia.