Afraid of the Cold: Mitral Valve Replacement in a Patient with Cold Agglutinins

Abstract A 40-year-old male presented with symptomatic severe mitral stenosis and moderate mitral insufficiency and was recommended to undergo mitral valve replacement. While undergoing preoperative workup, the patient was found to have positive cold agglutinin (CA) autoantibodies. The patient underwent a successful mechanical mitral valve replacement with maintenance of systemic normothermia and myocardial hypothermia. Postoperatively, no neurologic or thrombotic sequelae were observed and the patient was discharged home with no complications. We propose a management approach to patients with CAs that affords myocardial hypothermia in patients requiring cardiac surgery.