[Effect of fibrinogen concentrate on coagulopathy patient with left ventricular assist system in surgical repair of thoracic abdominal aortic aneurysm (TAAA): a case report].

We describe a case in which fibrinogen concentrate was useful to improve anticoagulation after aortic graft replacement. A 44-year-old man with left ventricular assist system (LVAS) underwent thoracic abdominal aortic aneurysm (TAAA) graft replacement. LVAS requires anticoagulant therapy for thromboprophylaxis. Therefore, we supposed that it would be difficult to stop bleeding in TAAA graft replacement surgery. For this reason, we planned to administer fibrinogen concentrate during the surgery. When the patient was weaned from cardiopulmonary bypass, blood fibrinogen value decreased to 58.0 mg x dl(-1). At this time, we administered fibrinogen concentrate 6 g with other blood preparations. After the administration of fibrinogen concentrate, calculated blood fibrinogen level increased immediately to 120.0 mg x dl(-1). Three hours after administration of fibrinogen concentrate, TAAA graft replacement operation was finished. Ten days after the surgery, he was discharged from the ICU. Fibrinogen concentrate might be useful in difficult hemostasis reducing consumption of blood preparations.