Coronary artery bypass grafting in a patient with protein S deficiency: Perioperative implications

Baskaran Balan*, Suresh Chengode, Hilal Al Sabti, Ram Narayan Rao

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation therapy. The risk of developing thrombotic complications is heightened in the perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Heparin resistance is very rare in these patients, especially when antithrombin levels are near normal. Management of CPB in this scenario is quite challenging. We report the perioperative management, particularly the CPB management, of a patient with type I PS deficiency and incidentally detected heparin resistance, who underwent coronary artery bypass grafting with CPB.

Original languageEnglish
Pages (from-to)232-236
Number of pages5
JournalAnnals of Cardiac Anaesthesia
Issue number3
Publication statusPublished - 2014


  • Cardiopulmonary bypass
  • Coronary artery bypass grafting
  • Heparin resistance
  • Hypercoagulable states
  • Protein S deficiency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine


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