Deep-Vein Thrombosis and Congenital Thrombophilia

Authors

Keywords:

deep-vein thrombosis, congenital thrombophilia, spinal anesthesia, thromboprophylaxis.

Abstract

Introduction: Thrombophilia is a congenital or acquired hemostasis disorder that predisposes to thrombosis development. The commonest congenital thrombophilias are deficiencies of antithrombin III, protein C and protein S, factor V Leiden, prothrombin gene mutation (G20210A), and methylenetetrahydrofolate reductase (MTHFR) mutations.

Objective: To describe the anesthetic management in a patient with congenital thrombophilia.

Case presentation: The case is reported of a 19-year-old patient with a family and personal history of deep-vein thrombosis, treatment with double antiplatelet therapy and association of three mutations for congenital thrombophilia (G20210A, A1298C MTHFR and C677T MTHFR), who receives spinal anesthesia for an inguinal herniorrhaphy. Aspirin treatment is maintained. Clopidogrel is suspended seven days before surgery. During this time, fraxiparin is administered subcutaneously in 0.6-mL units daily, up to twelve hours before surgery. Elastic stockings are used, early ambulation is allowed, and clopidogrel is restarted 24 hours after surgery, with satisfactory evolution.

Conclusions: Thromboprophylaxis in patients with congenital thrombophilia is mandatory, a reason why the use of low-molecular-weight heparin, together with the rest of the prevention measures against deep-vein thrombosis, is decisive.

 

Keywords: deep-vein thrombosis; congenital thrombophilia; spinal anesthesia; thromboprophylaxis.

 

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Author Biographies

Osmany Cruz García, Hospital Universitario Celestino Hernández Robau

Especialista de Primer Grado en Anestesiología y Reanimación, profesor asistente, Msc. Atención Integral a la Mujer.

Carlos Gilberto Nieto Monteagudo, Hospital Universitario Celestino Hernández Robau

Especialista de Segundo Grado en Anestesiología y Reanimación, profesor auxiliar

Lester Alvárez Hurtado, Hospital Universitario Celestino Hernández Robau

Especialista de Primer Grado en Anestesiología y Reanimación, profesor instructor, Msc. Urgencias Médicas

Yassel Cruz Hernández, Policlínico Universitario Chiqui Gómez Lubián

Residente de tercer año de Medicina General Integral

Marlon Cruz Hernández, Universidad Ciencias Médicas Villa Clara

Estudiante de quinto año de Medicina. Alumno Ayudante de Anestesiología y Reanimación

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Published

2020-07-31

How to Cite

1.
Cruz García O, Nieto Monteagudo CG, Alvárez Hurtado L, Cruz Hernández Y, Cruz Hernández M. Deep-Vein Thrombosis and Congenital Thrombophilia. Rev Cub Anest Rean [Internet]. 2020 Jul. 31 [cited 2025 May 11];20(2). Available from: https://revanestesia.sld.cu/index.php/anestRean/article/view/691

Issue

Vol. 20 No. 2 (2021): May - August (In progress)

Section

Case reports

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