Transient Cold Hemagglutinin Disease (CHAD) During Cardiac Surgery: An Unexpected Complication from Hypothermia.
- 1Departement of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Abstract
A 74-year-old male with mild non-specific anaemia underwent elective mitral and tricuspid valve surgery. Following initiation of cardiopulmonary bypass (CPB), systemic cooling to 34℃ and cardioplegia at 4℃, upon cardiotomy, clumps of blood were noted in the left atrium and left ventricle. ACT was confirmed to be in range, therefore a blood sample from CPB machine was collected and when exposed to ice demonstrated clumps, while they disappeared once at normal temperature. Hence, the patient was rewarmed to 37℃, subsequent cardioplegia doses were delivered warm and the heart chambers were washed out. Mitral and tricuspid valve repair were carried out uneventfully and the patient made an uncomplicated recovery. Positive direct antiglobulin test confirmed CHAD, a form of autoimmune haemolytic anaemia involving IgM autoantibodies against red blood cells triggered by low temperature. The prompt intraoperative identification and subsequent modifications of surgical strategy potentially averted severe embolic and ischemic complications.
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BibTeX
@article{dalessio2026transient,
title = {{Transient Cold Hemagglutinin Disease (CHAD) During Cardiac Surgery: An Unexpected Complication from Hypothermia.}},
author = {Andrea D'Alessio and Ali Ansaripour and Samail Shahjahan and Joshua Oliver and Charles Chan and Vivek Srivastava},
journal = {Journal of cardiovascular and thoracic research},
year = {2026},
month = jun,
doi = {10.34172/jcvtr.33536},
url = {https://europepmc.org/article/MED/42898292},
note = {CC BY},
}
RIS
TY - JOUR
TI - Transient Cold Hemagglutinin Disease (CHAD) During Cardiac Surgery: An Unexpected Complication from Hypothermia.
AU - Andrea D'Alessio
AU - Ali Ansaripour
AU - Samail Shahjahan
AU - Joshua Oliver
AU - Charles Chan
AU - Vivek Srivastava
PY - 2026
DA - 2026/06/30
JO - Journal of cardiovascular and thoracic research
DO - 10.34172/jcvtr.33536
UR - https://europepmc.org/article/MED/42898292
AB - A 74-year-old male with mild non-specific anaemia underwent elective mitral and tricuspid valve surgery. Following initiation of cardiopulmonary bypass (CPB), systemic cooling to 34℃ and cardioplegia at 4℃, upon cardiotomy, clumps of blood were noted in the left atrium and left ventricle. ACT was confirmed to be in range, therefore a blood sample from CPB machine was collected and when exposed to ice demonstrated clumps, while they disappeared once at normal temperature. Hence, the patient was rewarmed to 37℃, subsequent cardioplegia doses were delivered warm and the heart chambers were washed out. Mitral and tricuspid valve repair were carried out uneventfully and the patient made an uncomplicated recovery. Positive direct antiglobulin test confirmed CHAD, a form of autoimmune haemolytic anaemia involving IgM autoantibodies against red blood cells triggered by low temperature. The prompt intraoperative identification and subsequent modifications of surgical strategy potentially averted severe embolic and ischemic complications.
SN - 2008-5117
SN - 2008-6830
ER -