Hasegawa Tomomi, Oshima Yoshihiro, Maruo Ayako, Matsuhisa Hironori
Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
Interact Cardiovasc Thorac Surg. 2012 Mar;14(3):333-4. doi: 10.1093/icvts/ivr117. Epub 2011 Dec 18.
Cold agglutinins (CAs) lead to organ thrombosis or haemolysis due to increased blood viscosity and red blood cell clumping when blood temperature drops below the thermal amplitude for haemagglutination. Although it is well known that CAs are particularly relevant to adult cardiac surgery with hypothermic cardiopulmonary bypass (CPB), paediatric cardiac surgery with congenital heart disease and with CAs has been reported very rarely. We present here a case of paediatric cardiac surgery to repair atrial septal defect with pulmonary stenosis in an 11-month old infant with a family history of CAs. She was detected to have a high titre of CAs preoperatively, and underwent an intracardiac repair with normothermic CPB using temporary electrical fibrillation for added safety. Her post-operative course was uneventful without any complications.
冷凝集素（CAs）在血液温度降至血凝温度范围以下时，会因血液粘度增加和红细胞凝集而导致器官血栓形成或溶血。尽管众所周知CAs与成人低温体外循环心脏手术密切相关，但关于患有先天性心脏病且伴有CAs的小儿心脏手术的报道却非常罕见。我们在此报告一例11个月大患有CAs家族史的婴儿，因肺动脉狭窄行房间隔缺损修补术的小儿心脏手术病例。术前检测发现她的CAs滴度很高，手术采用常温体外循环、临时电除颤以增加安全性进行心内修复。术后恢复顺利，无任何并发症。
