J Cardiovasc Surg
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Case Reports
Disseminated intravascular coagulopathy associated with thromboexclusion for dissecting aortic aneurysm.
Disseminated intravascular coagulopathy (DIC) was demonstrated in a patient who underwent surgical thromboexclusion by blood flow reversal for dissecting aortic aneurysm. Large clots in the descending thoracic aorta and extra-anatomic bypass grafting might have been causative factors of the consumption coagulopathy. Low-dose heparin together with fresh-frozen plasma was effective; however, extreme caution should be adopted with such patients to minimize the development of DIC, because the factors responsible for the coagulation abnormalities are not removed in patients who undergo the surgical treatment of thromboexclusion.
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Between October 1981 and December 1983 21 premature infants of mean gestational age 27.5 weeks (range 26-29 weeks) underwent surgical closure of persistent ductus arteriosus. Mean birth weight was 1080 g. There was no operative mortality. ⋯ In 18 infants a trial of Indomethacin therapy had failed. This experience supports the view that surgical closure of PDA in infants born before 30 weeks gestation can be accomplished safely. We believe that surgical treatment of PDA represents the optimal therapy in this high risk group of infants.