Cold Agglutinin Autoantibodies in a Patient without a Visible Coronary Sinus Ostium: Strategies for Myocardial Protection without Using Retrograde Cardioplegia.
The presence of cold agglutinins (CA) during cardiac surgery with cardiopulmonary bypass usually creates the need for an altered surgical plan. In this case, the CA were discovered after the initiation of bypass, limiting the time, and cardioplegia solutions that could be used in the new approach. The inability to cannulate the coronary sinus with a retrograde cardioplegia catheter excluded the standard approach to myocardial preservation with CA of using continuous warm blood. For this case, we used intermittent cold crystalloid delivered via the antegrade needle for the first half of the procedure and through the saphenous vein graft anastomosis during the aortic valve portion of the cross-clamp period.
['Heath|Michele|M|', 'Yalamuri|Suraj|S|', 'Walker|Julie|J|', 'Maxwell|Cory|C|', 'Williams|Adam|A|', 'McCartney|Sharon|S|', 'Daneshmand|Mani|M|']
D001323:Autoantibodies D002314:Cardioplegic Solutions D001026:Coronary Artery Bypass D054326:Coronary Sinus D006324:Heart Arrest, Induced D006801:Humans
coronary sinus cardioplegia antibody/antigen hematology