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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2000 August;41(4):595-9

VASCULAR PAPERS 

    ORIGINAL ARTICLES

An analysis of risk factors of perioperative bleeding in surgical repair of abdominal aortic aneurysm

Miyashita T., Ando M. *, Hanafusa Y. *, Onishi Y., Kuro M.

From the Department of Anesthesiology and *Cardiovascular Surgery National Cardiovascular Center Suita, Osaka, Japan

Background. In sur­gi­cal ­repair of abdom­i­nal aor­tic aneu­rysm (AAA), exces­sive bleed­ing ­which caus­es post­op­er­a­tive com­pli­ca­tions is some­times ­observed. To deter­mine the ­risk fac­tors of per­i­op­er­a­tive exces­sive ­blood ­loss, ­this ret­ro­spec­tive ­study was per­formed.
Methods. Design. A ret­ro­spec­tive ­study. Setting. An aca­dem­ic med­i­cal cen­ter. Participants. One hun­dred and for­ty ­patients under­went elec­tive sur­gi­cal ­repair of an abdom­i­nal aor­tic aneu­rysm (AAA) at our insti­tu­tion ­from 1995 ­through 1997. Measurements. The ­present ­study ­includes crit­i­cal ­review of 140 con­sec­u­tive ­charts of ­patients under­go­ing elec­tive sur­gi­cal ­repair of AAA. Preoperative labor­a­to­ry ­data, intra­op­er­a­tive ­data and ­amount of ­blood ­loss to iden­ti­fy ­risk fac­tors of per­i­op­er­a­tive ­blood ­loss. Factors ­which ­were ­found to be sig­nif­i­cant­ly asso­ciat­ed ­with the ­amount of per­i­op­er­a­tive ­blood ­loss ­were pre­op­er­a­tive plas­ma ­fibrin deg­ra­da­tion prod­uct (FDP) lev­el (r=0.445), ­amount of imme­di­ate re-in­fu­sion of ­shed ­blood (r=0.438), and dura­tion of oper­a­tion (r=0.411).
Results. Preoperative fibrino­gen lev­el cor­re­lat­ed ­with per­i­op­er­a­tive ­blood ­loss lit­tle (r=-0.187). Preoperative plate­let ­count or the oth­er coag­u­la­tion pro­file did not ­affect the ­amount of per­i­op­er­a­tive ­blood ­loss. The ­patients ­whose pre­op­er­a­tive FDP ­were ­more ­than 40μg·ml-1 sig­nif­i­cant­ly ­increased the ­risk of exces­sive ­blood ­loss com­pared ­with ­less ­than 40 μg·ml-1.
Conclusions. The sig­nif­i­cant pre­op­er­a­tive ­risk fac­tor of per­i­op­er­a­tive ­blood ­loss was ­only FDP lev­el in ­present ­study. Especially, the ­patients ­whose pre­op­er­a­tive FDP ­were ­more ­than 40 μg·ml-1 ­increased the ­risk of exces­sive ­blood ­loss.

language: English


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