Abstract
Although progress in cardiac surgery has been extensive, and mortality rates for most procedures continue to decline, postoperative bleeding has remained a potentially life-threatening complication of heart surgery. Management frequently results in excessive blood product administration and reoperation is necessary in 3% to 5% of all open-heart procedures.1–3 Excessive bleeding may be the result of inadequate surgical hemostasis, preexisting coagulopathic states, or coagulopathy related to cardiopulmonary bypass.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Mills NL. Postoperative hemorrhage after cardiopulmonary bypass.Ann Thorac Surg 1982;34:607.
Salm T. Two techniques for the control of cardiac bleeding. Ann Thorac Surg 1994;57:762–764.
Harker L. Bleeding after cardiopulmonary bypass (editorial). N Engl J Med 1988;314:1446–1447.
Duke W. The relation of blood platelets to hemorrhagic diseases. JAMA 1910;60:1185–1192.
Turrito V, Baumgartner H. Platelet interactions with subendothelium in a perfusion system: physical role of red blood cells. Microvasc Res 1975;9:335–344.
Turrito V, Weiss H. Red blood cells: their dual role in thrombus formation. Science 1980;207:541–543.
Blajchman M, Bordin J, Bardossy L, et al. The contribution of haematocrit to thrombocytopenic bleeding in experimental animals. Br J Haematol 1994;86:347–350.
Anand A, Feffer S. Hematocrit and bleeding time: an update. South Med J 1994;87:299–301.
Woodman R, Harker L. Bleeding complications associated with cardiopulmonary bypass. Blood 1990;76:1680–1697.
Salzman E, Weinstein M, Weintraub R, et al. Treatment with desmopressin acetate to reduce blood loss after cardiac surgery. N Engl J Med 1986;314:1402–1406.
Kaiser G, Naunheim K, Fiore A, et al. Reoperation in the intensive care unit. Ann Thorac Surg 1990;49:903–908.
Reed R II, Bracy A Jr, Hudson J, et al. Hypothermia and blood coagulation: dissociation between enzyme activity and clotting factor levels. Circ Shock 1990;32:141–152.
Valeri C, Hhabbaz K, Khuri S, et al. Effect of skin temperature on platelet function in patients undergoing extracorporeal bypass. J Thorac Cardiovasc Surg 1992;104:108–116.
Valeri C, Cassidy G, Khuri S, et al. Hypothermia-induced reversible platelet dysfunction. Ann Surg 1987;205:175–181.
Cooley D. Techniques in Cardiac Surgery 2nd ed. Philadelphia: W.B. Saunders, 1984;4–5.
McCarthy P. Fibrin glue in cardiothoracic surgery. Transf Med Rev 1993;7:173–179.
Borst H, Haverich A, Walterbusch G, et al. Fibrin adhesive: an important hemostatic adjunct in cardiovascular operations. J Thorac Cardiovasc Surg 1982;84:548–553.
Jessen C, Sharma P. Use of fibrin glue in thoracic surgery. Ann Thorac Surg 1985;39:521–524.
Tawes R, Sydorak G, DuVall T. Autologous fibrin glue: the last step in operative hemostasis. Am J Surg 1994;168:120–122.
Gibble J, Ness P. Fibrin glue: the perfect operative sealant? Transfusion 1990;30:741–747.
Sierra DH. Fibrin sealant adhesive systems: a review of their chemistry, material properties and clinical applications. J Biomat Appl 1993;7:309–352.
Johnson J, Gundersen E, Stickney I, et al. Selective approach to sternal closure after exploration for hemorrhage following coronary artery bypass. Ann Thorac Surg 1990;49:771–774.
Bouboulis N, Rivas J, Juo J, et al. Packing the chest: a useful technique for intractable bleeding after open heart operation. Ann Thorac Surg 1994;57:856–861.
Hill J, Rodvien R, Mielke C. Bleeding and hemorrhagic complications. In: Litwak R, Jurado R, eds. Care of the Cardiac Surgical Patient Norwalk, CT: Appleton-Century-Crofts, 1982;380–381.
Unsworth-White M, Herriot A, Valencia O, et al. Resternotomy for bleeding after cardiac operation: a marker for increased morbidity and mortality. Ann Thorac Surg 1995;59:664–667.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag New York, Inc.
About this chapter
Cite this chapter
Lang, S.J. (1998). Reoperative Strategies for the Bleeding Cardiovascular Patient. In: Krieger, K.H., Isom, O.W. (eds) Blood Conservation in Cardiac Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2180-7_22
Download citation
DOI: https://doi.org/10.1007/978-1-4612-2180-7_22
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-94908-6
Online ISBN: 978-1-4612-2180-7
eBook Packages: Springer Book Archive