Case Report

Deep Hypothermic Circulatory Arrest for Emergency Repair of Type A Aortic Dissection in a Patient with Cold Agglutinins

Address correspondence to: Syena Sarrafpour, MD, Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, 330 Brookline Ave., Boston, MA 02215. E-mail: ssarrafp@bidmc.harvard.edu The senior author has stated that the authors have reported no material, financial, or other relationship with any healthcare-related business or other entity whose products or services are discussed in this paper.

Received: 30 March 2021
Accepted: 16 August 2021

Abstract

Cold agglutinins (CA) are auto-antibodies that adhere to erythrocytes in cold temperatures, and can result in agglutination of red blood cells. This process can cause complement-mediated intravascular hemolysis, which can be catastrophic. We describe a patient who developed CA during initiation of deep hypothermic circulatory arrest for emergent repair of Type A aortic dissection. The patient was found to have anti-I and anti-C antibodies and a positive direct Coombs test. CA resolved with re-warming, and resulted in no adverse events.