Hyperhomocysteinemia, antithrombin consumption, and early venous graft closure in surgical coronary revascularization

M. Ranucci, F. Romitti, E. Costa

Research output: Contribution to journalArticle

Abstract

Hyperhomocysteinemia is a pathological condition that increases cardiovascular risk due to prothrombotic behaviour in the patient. This case report concerns a 61-year-old man undergoing surgical coronary revascularization for early thrombosis of the venous graft. The postoperative antithrombin activity was extremely low (33%), despite normal preoperative values (79%) and a short cardiopulmonary bypass. At a subsequent screening, the patient was diagnosed with hyperhomocysteinemia (18.4 μmol/L) due to a heterozygous C677T mutation of the enzyme methylenetetrahydrofolate reductase associated with a folate deficiency. Hyperhomocysteinemia and cardiac operation are both factors that induce increased thrombin formation, which may induce antithrombin consumption and a consequent thrombotic event. Further studies are needed to define hyperhomocysteinemia as an independent risk factor for thrombotic events after cardiac surgery.

Original languageEnglish
Pages (from-to)439-442
Number of pages4
JournalMinerva Anestesiologica
Volume74
Issue number7-8
Publication statusPublished - Jul 2008

Keywords

  • Antithrombins
  • Cardiopulmonary bypass
  • Coronary artery disease, surgery
  • Homocysteine
  • Myocardial infarction

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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