GKD Anest Yoð Bak Dern Derg. 2015; 21(4): 185-187 | DOI: 10.5222/GKDAD.2015.185

Unexpected coagulation in the bypass pump circuit

Baþar Erdivanlý¹, Þahin Bozok², Þaban Ergene², Tahir Ersöz¹, Nebiye Tüfekçi^2
1Department Of Anesthesiology And Reanimation, Recep Tayyip Erdogan University, Rize, Turkey
²Department Of Cardiovascular Surgery, Recep Tayyip Erdogan University, Rize, Turkey

We present a case of premature coagulation in the bypass pump circuit. Fifty-nine years-old female (Euroscore: 5) presented with acute heart failure and pulmonary oedema due to mitral valve stenosis. Following one vessel coronary bypass and mitral valve replacement (cross clamp time: 170 minutes), the blood collected before heparinization had to be transfused due to persistent bleeding. A short while after the transfusion, we had to initiate the backup bypass machine due to coagulation in the pump circuit. We are in opinion that the whole blood with fresh coagulation factors activated the intrinsic pathway in the pump circuit and caused the coagulation.

Keywords: Activated Coagulation Time, Agglutination, Cardiopulmonary Bypass

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Bypass pompa devresinde beklenmeyen pýhtýlaþma

Baþar Erdivanlý¹, Þahin Bozok², Þaban Ergene², Tahir Ersöz¹, Nebiye Tüfekçi^2
1Recep Tayyip Erdoðan Üniversitesi Eðitim Ve Araþtýrma Hastanesi, Anesteziyoloji Ve Reanimasyon Anabilim Dalý, Rize, Türkiye
²Recep Tayyip Erdoðan Üniversitesi Eðitim Ve Araþtýrma Hastanesi, Kalp Ve Damar Cerrahisi Anabilim Dalý, Rize, Türkiye

Baypas pompa devresinde erken koagulasyon gözlenen bir vakayý sunduk. Elli dokuz yaþýnda kadýn hasta (Euroscore: 5), mitral kapak darlýðýna baðlý akut kalp yetmezliði ve pulmoner ödemle baþvurdu. Tek damar greftleme ve mitral kapak replasmaný sonrasýnda (kros klemp süresi: 170 dakika), inatçý bir kanama nedeniyle, heparinizasyon öncesi hastadan alýnan 500 ml tam kaný vermek zorunda kaldýk. Transfüzyondan kýsa süre sonra, devrede pýhtýlaþma nedeniyle yedek baypas pompasýna geçmek zorunda kaldýk. Taze pýhtýlaþma faktörleri içeren tam kanýn, pompa devresinde intrinsik yolaðý aktive ettiði ve pýhtýlaþmaya neden olduðu kanaatindeyiz.

Anahtar Kelimeler: Aktive pýhtýlaþma zamaný, Aglütinasyon, Kardiyopulmoner baypas

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