Antiphospholipid syndrome and perioperative hemostatic management of cardiac valvular surgery

Hemostatic aspects of antiphospholipid syndrome (APS) present unique challe nges to clinicians and laboratory personnel alike, particularly in the peri operative period. These challenges are especially evident in patients requi ring cardiac valve replacement surgery, However, the literature outlining t he optimal approach in such patients is limited. We present the case of a 2 5-year-old woman with severe aortic regurgitation as a result of APS with p articular reference to the precautions necessary during perioperative care. Particularly important are the prevention of thrombotic or hemorrhagic com plications, management of associated thrombocytopenia, and laboratory metho ds of perioperative anticoagulation monitoring in the setting of prolonged clotting times.