We present a case of two separated life-threatening postoperative bleeding complications after mandible cancer resection and microsurgical fibula flap in a patient under permanent warfarin treatment. We used fresh frozen plasma, prothrombin complex concentrate to control bleedings. We consider to maintain similar patients in heparin/enoxaparin bridging for 1-2 weeks.
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http://dx.doi.org/10.1080/23320885.2019.1699416 | DOI Listing |
Cureus
December 2024
Department of Surgery, Tokyo Saiseikai Central Hospital, Tokyo, JPN.
Ectopic varices can result from portal vein stenosis following pancreaticoduodenectomy with concomitant portal vein resection reconstruction, and they can cause gastrointestinal bleeding. Although they can sometimes be fatal, various treatments have been reported. This report describes a case in which a percutaneous transhepatic approach was used to simultaneously perform variceal embolization and portal vein stenting in which a favorable outcome was achieved.
View Article and Find Full Text PDFJTCVS Open
December 2024
Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
Objective: To evaluate the effectiveness of the five-minute drainage assessment (FMDA) in preventing reexploration for bleeding following cardiovascular surgery.
Methods: This retrospective review included 1280 patients who underwent cardiovascular surgery between January 2017 and August 2021. Patients were divided into control (n = 695) and FMDA (n = 585) groups.
J Cardiothorac Surg
January 2025
Cardiac Surgery Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, Sichuan Province, 610072, China.
Objective: To explore the safety and efficacy of low-intensity anticoagulation in patients after On-X mechanical aortic valve replacement.
Methods: A total of 104 patients undergoing aortic valve replacement in Cardiac Surgery Department of Sichuan Provincial People's Hospital from December 2018 to December 2021 were randomly divided into low-intensity anticoagulant (INR:1.5-2.
BMJ Open Qual
January 2025
Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Transfusion of blood products following cardiothoracic surgery represents a significant proportion of national blood product usage, has significant cost implications and is associated with increased 30-day mortality. Following identification of an increase in blood product use, we implemented a healthcare improvement initiative using a perioperative care model and establishment of a new multispecialty cardiothoracic surgery taskforce to further define and tackle the problem. The initiative incorporated a bundle of preoperative identification of high-risk patients, an intraoperative haemostasis checklist, a programme of unit education focussing on bleeding postbypass and use of thromboelastography and introduction of postoperative protocols for identification and escalation of bleeding.
View Article and Find Full Text PDFAnasthesiol Intensivmed Notfallmed Schmerzther
January 2025
After severe trauma, but also perioperatively, massive bleeding is associated with increased morbidity and mortality. In severely injured patients, hemorrhagic shock remains to be the main cause of death in addition to traumatic brain hemorrhage. In non-cardiac surgery, a surgical bleeding complication increases perioperative morbidity (intensive care length of stay, acute renal failure, infections, thromboembolic complications) by a factor of three to four and mortality by a factor of six.
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