Division of Plastic and Reconstructive Surgery, Department of Surgery, University Hospital of Zurich, Rämistrasse 100, Zurich, Switzerland.
Clin Appl Thromb Hemost. 2010 Apr;16(2):199-203. doi: 10.1177/1076029608325546. Epub 2008 Nov 19.
The transverse rectus abdominis muscle flap is widely used in free microvascular tissue transfer for breast reconstruction following mastectomy. Flap survival may be compromised by failure at the microsurgical anastomosis due to both venous and arterial thrombosis. It is unclear, whether hereditary thrombophilia represents a risk factor for early thrombotic occlusion following free flap procedures. We present a case of a patient with previously diagnosed activated protein C resistance caused by heterozygous factor V (position 1691 G-->A) Leiden mutation in whom a free transverse rectus abdominis muscle flap was performed. The postoperative course was complicated by repeated thrombosis of both the venous and arterial part of the anastomosis. Immediate thrombectomy and repeated arteriography allowed for partial flap salvage. More data are needed to analyze the impact of hereditary thrombophilia on microvascular anastomosis failure.
横直肌腹皮瓣在乳腺癌根治术后游离皮瓣移植乳房再造中被广泛应用。由于静脉和动脉血栓形成，皮瓣的存活可能会受到显微吻合术失败的影响。目前尚不清楚遗传性血栓形成倾向是否是游离皮瓣手术后早期血栓闭塞的危险因素。我们报告了 1 例先前诊断为杂合子因子 V（位置 1691 G->A）莱顿突变导致激活蛋白 C 抵抗的患者，该患者接受了游离横直肌腹皮瓣手术。术后过程中，吻合口的静脉和动脉部分反复发生血栓形成。立即血栓切除术和重复动脉造影术允许部分皮瓣挽救。需要更多的数据来分析遗传性血栓形成倾向对微血管吻合失败的影响。
