Early Postoperative Immunothrombosis of Bioprosthetic Mitral Valve and Left Atrium: A Case Report
Abstract
:1. Introduction
2. Case Presentation
3. Investigation and Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Coagulation Parameters | Before inVR (22 January) | Between inVR and repVR (31 January) | After the repVR (2 February) | Before Patient Death (4 February) | Reference Range |
---|---|---|---|---|---|
International normalized ratio | 1.20 | 1.25 | 1.33 | 1.18 | 0.9–1.5 (healthy individuals) 2.0–3.0 (those on anticoagulant therapy) |
Prothrombin time (Quick-type), % | 69 | 63 | 54 | 71 | 80–120 |
Soluble fibrin monomer complexes, mg/100 mL | 17.0 | 6.5 | 4.5 | 10.0 | <4.0 |
Activated partial thromboplastin time, sec | 29 | 53 | 115 | 50 | 24–35 |
Fibrinogen, g/L | 5.2 | 3.0 | 3.5 | 3.3 | 2–4 |
Protein C activity, % | 80.0 | ND | ND | ND | 70–140 |
Antithrombin III, % | 86.3 | ND | ND | ND | 80–120 |
XIIa-dependent fibrinolysis, min | 14 | ND | ND | ND | 4–12 |
Complete Blood Count Parameters | Before inVR (21 January) | Between inVR and repVR (31 January) | After the repVR (2 February) | Before Patient Death (4 February) | Ref. Range |
---|---|---|---|---|---|
Erythrocyte sedimentation rate, mm/h | 17 | 24 | 59 | 51 | 2–15 |
Hemoglobin, g/L | 155 | 114 | 97 | 98 | 117–145 |
Red blood cells, ×1012/L | 4.9 | 3.6 | 3.3 | 3.4 | 3.7–4.7 |
Platelets, ×109/L | 253 | 94 | 69 | 15 | 170–350 |
Hematocrit, % | 45 | 33 | 29 | 30 | 36–42 |
White blood cells, ×109/L | 10.0 | 14.0 | 8.7 | 10.9 | 4.0–8.8 |
Band neutrophils, % | 5 | 2 | 10 | 7 | 1–6 |
Segmented neutrophils, % | 80 | 92 | 78 | 84 | 45–72 |
Eosinophils, % | 0 | 0 | 0 | 0 | 0–5 |
Basophils, % | 0 | 0 | 0 | 0 | 0–1 |
Lymphocytes, % | 9 | 2 | 7 | 5 | 18–40 |
Monocytes, % | 6 | 4 | 5 | 4 | 3–9 |
Gene | Polymorphism | Genotype | Protein | Physiological Effect in the Patient Case |
---|---|---|---|---|
Coagulation Factors | ||||
F2 | rs1799963 | G/G | Factor II (prothrombin) | None |
F5 | rs6025 (Leiden) | G/G | Factor V (proaccelerin) | None |
rs6027 | G/G | None | ||
F7 | rs6046 | G/G | Factor VII (proconvertin) | None |
F13A1 | rs5985 | G/T | Factor XIII α chain (fibrin-stabilizing factor) | Lower fibrin clot permeability, prolonged clot lysis time, higher endogenous thrombin potential [16] |
FGB | rs1800790 | G/G | Fibrinogen β chain | None |
Platelets | ||||
ITGA2 | rs1126643 | C/T | Integrin α2 (CD49b) | Increased platelet aggregation [17] |
ITGB3 | rs5918 | T/C | Integrin β3 (CD61) | Increased fibrinogen and platelet adhesion, accelerated clot retraction [18] |
Fibrinolysis | ||||
SERPINE1 | rs1799889 | 4G/4G | Plasminogen activator inhibitor-1 | Higher PAI-1 serum level, impaired fibrinolysis [19] |
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Kostyunin, A.; Glushkova, T.; Stasev, A.; Mukhamadiyarov, R.; Velikanova, E.; Bogdanov, L.; Sinitskaya, A.; Asanov, M.; Ovcharenko, E.; Barbarash, L.; et al. Early Postoperative Immunothrombosis of Bioprosthetic Mitral Valve and Left Atrium: A Case Report. Int. J. Mol. Sci. 2022, 23, 6736. https://doi.org/10.3390/ijms23126736
Kostyunin A, Glushkova T, Stasev A, Mukhamadiyarov R, Velikanova E, Bogdanov L, Sinitskaya A, Asanov M, Ovcharenko E, Barbarash L, et al. Early Postoperative Immunothrombosis of Bioprosthetic Mitral Valve and Left Atrium: A Case Report. International Journal of Molecular Sciences. 2022; 23(12):6736. https://doi.org/10.3390/ijms23126736
Chicago/Turabian StyleKostyunin, Alexander, Tatiana Glushkova, Alexander Stasev, Rinat Mukhamadiyarov, Elena Velikanova, Leo Bogdanov, Anna Sinitskaya, Maxim Asanov, Evgeny Ovcharenko, Leonid Barbarash, and et al. 2022. "Early Postoperative Immunothrombosis of Bioprosthetic Mitral Valve and Left Atrium: A Case Report" International Journal of Molecular Sciences 23, no. 12: 6736. https://doi.org/10.3390/ijms23126736