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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2008 July-August;74(7-8):439-42

language: English

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

Ranucci M. 1, Romitti F. 1, Costa E. 2

1 Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, Polyclinic Hospital S. Donato IRCCS, Milan, Italy;
2 Clinical Laboratory, Polyclinic Hospital S. Donato IRCCS, Milan, Italy


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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.

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