D'Aloiso Brandon D, Rupchak Sarah S, Gettle Kaitlin J, Lima Claudio, Rush Robert D
School of Cardiovascular Perfusion, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
J Extra Corpor Technol. 2018 Jun;50(2):120-123.
Waldenström's Macroglobulinemia (WM) is a rare lymphoma caused by the overproduction of immunoglobulin M (IgM). The elevated level of IgM causes serum hyperviscosity, cold agglutinins, and cryoglobulinemia. Anemia is also present because of impaired production of erythrocytes. For these reasons, placing a patient with WM on cardiopulmonary bypass (CPB) requires careful preparation. In this case, the patient was a 73-year-old male with known Waldenström's disease who required coronary artery bypass graft surgery. This report details the perioperative considerations used for successful CPB on a Waldenström's patient. Critical to this case was the use of plasmapheresis before surgery. Temperature management and acid/base status were carefully controlled. A successful coronary revascularization surgery was performed. Many of the Wadenstrom's disease complications expected on CPB failed to materialize.
华氏巨球蛋白血症（WM）是一种由免疫球蛋白M（IgM）过度产生引起的罕见淋巴瘤。IgM水平升高会导致血清黏稠度增加、冷凝集素和冷球蛋白血症。由于红细胞生成受损，贫血也会出现。出于这些原因，让WM患者进行体外循环（CPB）需要仔细准备。在这个病例中，患者是一名73岁的男性，患有已知的华氏病，需要进行冠状动脉搭桥手术。本报告详细介绍了在一名华氏病患者身上成功进行CPB的围手术期注意事项。该病例的关键在于术前使用血浆置换。温度管理和酸碱状态得到了仔细控制。成功进行了冠状动脉血运重建手术。预计在CPB时会出现的许多华氏病并发症并未出现。
