In this report, we review 2 cases of coronary revascularization in patients with a diagnosis of coronary artery disease and preoperative protein S deficiency, an established hypercoagulable condition. In an attempt to normalize protein S levels, fresh frozen plasma was used as the priming fluid for the cardiopulmonary bypass circuit before the initiation of extracorporeal circulation. On the basis of a low risk of bleeding and the theoretical risk of thrombosis, neither patient received intraoperative antifibrinolytic treatment nor did they develop perioperative thrombotic complications.
From the Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
Yen-Michael S. Hsu, MD, PhD, is currently affiliated with Blood Centers of the Pacific and Department of Laboratory Medicine, University of California, San Francisco, California.
Accepted for publication September 27, 2013.
Funding: No funding required.
The authors declare no conflicts of interest.
Address correspondence to George J. Despotis, MD, Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., BOX 8118, St. Louis, MO 63110. Address e-mail to email@example.com.