Year : 2014  |  Volume : 17  |  Issue : 3  |  Page : 232--236

Coronary artery bypass grafting in a patient with protein S deficiency: Perioperative implications


Baskaran Balan1, Suresh Chengode2, Hilal Al Sabti1, Ram Narayan Rao2 
1 Division of Cardiothoracic Surgery, Sultan Qaboos University Hospital, Muscat, Oman
2 Department of Anaesthesia, Sultan Qaboos University Hospital, Muscat, Oman

Correspondence Address:
Baskaran Balan
Division of Cardiothoracic Surgery, Sultan Qaboos University Hospital, PO Box 35, Muscat
Oman

Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation therapy. The risk of developing thrombotic complications is heightened in the perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Heparin resistance is very rare in these patients, especially when antithrombin levels are near normal. Management of CPB in this scenario is quite challenging. We report the perioperative management, particularly the CPB management, of a patient with type I PS deficiency and incidentally detected heparin resistance, who underwent coronary artery bypass grafting with CPB.


How to cite this article:
Balan B, Chengode S, Al Sabti H, Rao RN. Coronary artery bypass grafting in a patient with protein S deficiency: Perioperative implications.Ann Card Anaesth 2014;17:232-236


How to cite this URL:
Balan B, Chengode S, Al Sabti H, Rao RN. Coronary artery bypass grafting in a patient with protein S deficiency: Perioperative implications. Ann Card Anaesth [serial online] 2014 [cited 2019 Aug 23 ];17:232-236
Available from: http://www.annals.in/article.asp?issn=0971-9784;year=2014;volume=17;issue=3;spage=232;epage=236;aulast=Balan;type=0