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Coagulopathy and Bleeding Management for Aortic Dissection Surgery

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Aortic Dissection and Acute Aortic Syndromes

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Abstract

In patients following aortic surgery, the prevention and treatment of bleeding requires a multimodal approach that includes targeting fibrinogen and platelet repletion, the use of anti-fibrinolytic agents, and evaluating surgical sources of bleeding. Prothrombin complex concentrates, and fibrinogen concentrates are becoming increasingly important components of treatment algorithms. With major hemorrhage, specific protocols for massive transfusion in conjunction with pharmacologic agents should be considered. Bleeding management algorithms using viscoelastic testing to guide targeted replacement are being used increasingly in complex cardiac surgical patients.

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Authors and Affiliations

  1. Cardiothoracic Anesthesiology, Critical Care, and Surgery (Cardiothoracic), Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA

    Jerrold H. Levy

  2. Cardiothoracic Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA

    Roman M. Sniecinski

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Correspondence to Jerrold H. Levy .

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Editors and Affiliations

  1. Rhode Island Hospital, Brown University, Providence, RI, USA

    Frank W. Sellke

  2. Department of Surgery, Baylor College of Medicine, Houston, USA

    Joseph S. Coselli

  3. Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Thoralf M. Sundt

  4. Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Joseph E. Bavaria

  5. Thoracic Cardiothoracic Surgery, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, RI, USA

    Neel R. Sodha

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Levy, J.H., Sniecinski, R.M. (2021). Coagulopathy and Bleeding Management for Aortic Dissection Surgery. In: Sellke, F.W., Coselli, J.S., Sundt, T.M., Bavaria, J.E., Sodha, N.R. (eds) Aortic Dissection and Acute Aortic Syndromes. Springer, Cham. https://doi.org/10.1007/978-3-030-66668-2_39

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