Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 6, Number 3, March 2015, pages 109-112

Intraoperative Detection of Cold Agglutinins During Cardiopulmonary Bypass in a Child


Figure 1.
Figure 1. Agglutination in the venous reservoir and oxygenator during hypothermia and cardiopulmonary bypass. The agglutination can be seen as a white aggregate forming in the reservoir (circle and arrows).


Table 1. Previous Reports of Anesthesia for Patients With Cold Agglutinins
Authors and referencePatient demographics
Fischer et al [11]A 60-year-old male with unstable angina, hypertension, and hypercholesterolemia for urgent coronary artery bypass grafting.
Kalra et al [13]A 38-year-old female with rheumatic heart disease with mitral stenosis and mitral regurgitation for mitral valve replacement.
Young et al [14]A 62-year-old male with long-standing, cold agglutinin disease, diabetes mellitus, ischemic heart disease with previous coronary stenting, B-cell in remission, and OSA for an abdomino-peroneal excision of the rectum for a Duke’s stage A low rectal carcinoma.
Bratkovic and Fahy [15]An 82-year-old female with worsening angina and decreased exercise tolerance, paroxysmal atrial fibrillation, diabetes mellitus, and dyslipidemia for coronary artery bypass graft surgery. Routine preoperative antibody screening for cross-matching revealed cold agglutinins. Further history revealed symptoms suggestive of cold agglutinin disease.
Aoki et al [16]A 76-year-old male with idiopathic cold hemagglutinin disease for myocardial revascularization.
Beebe et al [17]An 82-year-old, 60 kg female with idiopathic cold hemagglutinin disease for splenectomy and cholecystectomy.
Bracken et al [18]1) A 67-year-old male with type 2 diabetes mellitus, hypertension, and coronary artery disease for coronary revascularization.
2) A 54-year-old male with triple-vessel coronary artery disease for myocardial revascularization.