Consumption coagulopathy in acute aortic dissection: principles of management
Abstract Background The effect of acute aortic dissection itself on coagulopathy or surgery-related coagulopathy has never been specifically studied. The aim of the present study was to perioperatively describe consumption coagulopathy in patients with acute aortic dissection. Methods Sixty-six pati...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2017-06-01
|
Series: | Journal of Cardiothoracic Surgery |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s13019-017-0613-5 |
id |
doaj-62dfe936ffb9438ebf4aaa6704515e39 |
---|---|
record_format |
Article |
spelling |
doaj-62dfe936ffb9438ebf4aaa6704515e392020-11-24T20:55:16ZengBMCJournal of Cardiothoracic Surgery1749-80902017-06-011211810.1186/s13019-017-0613-5Consumption coagulopathy in acute aortic dissection: principles of managementYuyong Liu0Lu Han1Jiachen Li2Ming Gong3Hongjia Zhang4Xinliang Guan5Department of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular ProsthesesDepartment of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular ProsthesesDepartment of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular ProsthesesDepartment of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular ProsthesesDepartment of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular ProsthesesDepartment of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular ProsthesesAbstract Background The effect of acute aortic dissection itself on coagulopathy or surgery-related coagulopathy has never been specifically studied. The aim of the present study was to perioperatively describe consumption coagulopathy in patients with acute aortic dissection. Methods Sixty-six patients with acute type A aortic dissection were enrolled in this study from January 2015 to September 2016. Thirty-six patients with thoracic aortic aneurysms were used as a control group during the same period. Consumption coagulopathy was evaluated using standard laboratory tests, enzyme-linked immunosorbent assay and thromboelastograghy at five perioperative time-points. Results A significant reduction in clotting factors and fibrinogen was observed at the onset of acute aortic dissection. Enzyme-linked immunosorbent assay and thromboelastograghy also revealed a persistent systemic activation of the coagulation system and the consumption of clotting factors. In contrast, although platelet counts were consistently low, we did not find that platelet function was more impaired in the acute aortic dissection group than the control group. Conclusions After surgery, clotting factors and fibrinogen were more impaired than platelet function. Thus, we proposed that hemostatic therapy should focus on the rapid and sufficient supplementation of clotting factors and fibrinogen to improve consumption coagulopathy in patients with acute aortic dissection.http://link.springer.com/article/10.1186/s13019-017-0613-5Acute aortic dissectionClotting factorsConsumption coagulopathyFibrinogenPlatelets |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuyong Liu Lu Han Jiachen Li Ming Gong Hongjia Zhang Xinliang Guan |
spellingShingle |
Yuyong Liu Lu Han Jiachen Li Ming Gong Hongjia Zhang Xinliang Guan Consumption coagulopathy in acute aortic dissection: principles of management Journal of Cardiothoracic Surgery Acute aortic dissection Clotting factors Consumption coagulopathy Fibrinogen Platelets |
author_facet |
Yuyong Liu Lu Han Jiachen Li Ming Gong Hongjia Zhang Xinliang Guan |
author_sort |
Yuyong Liu |
title |
Consumption coagulopathy in acute aortic dissection: principles of management |
title_short |
Consumption coagulopathy in acute aortic dissection: principles of management |
title_full |
Consumption coagulopathy in acute aortic dissection: principles of management |
title_fullStr |
Consumption coagulopathy in acute aortic dissection: principles of management |
title_full_unstemmed |
Consumption coagulopathy in acute aortic dissection: principles of management |
title_sort |
consumption coagulopathy in acute aortic dissection: principles of management |
publisher |
BMC |
series |
Journal of Cardiothoracic Surgery |
issn |
1749-8090 |
publishDate |
2017-06-01 |
description |
Abstract Background The effect of acute aortic dissection itself on coagulopathy or surgery-related coagulopathy has never been specifically studied. The aim of the present study was to perioperatively describe consumption coagulopathy in patients with acute aortic dissection. Methods Sixty-six patients with acute type A aortic dissection were enrolled in this study from January 2015 to September 2016. Thirty-six patients with thoracic aortic aneurysms were used as a control group during the same period. Consumption coagulopathy was evaluated using standard laboratory tests, enzyme-linked immunosorbent assay and thromboelastograghy at five perioperative time-points. Results A significant reduction in clotting factors and fibrinogen was observed at the onset of acute aortic dissection. Enzyme-linked immunosorbent assay and thromboelastograghy also revealed a persistent systemic activation of the coagulation system and the consumption of clotting factors. In contrast, although platelet counts were consistently low, we did not find that platelet function was more impaired in the acute aortic dissection group than the control group. Conclusions After surgery, clotting factors and fibrinogen were more impaired than platelet function. Thus, we proposed that hemostatic therapy should focus on the rapid and sufficient supplementation of clotting factors and fibrinogen to improve consumption coagulopathy in patients with acute aortic dissection. |
topic |
Acute aortic dissection Clotting factors Consumption coagulopathy Fibrinogen Platelets |
url |
http://link.springer.com/article/10.1186/s13019-017-0613-5 |
work_keys_str_mv |
AT yuyongliu consumptioncoagulopathyinacuteaorticdissectionprinciplesofmanagement AT luhan consumptioncoagulopathyinacuteaorticdissectionprinciplesofmanagement AT jiachenli consumptioncoagulopathyinacuteaorticdissectionprinciplesofmanagement AT minggong consumptioncoagulopathyinacuteaorticdissectionprinciplesofmanagement AT hongjiazhang consumptioncoagulopathyinacuteaorticdissectionprinciplesofmanagement AT xinliangguan consumptioncoagulopathyinacuteaorticdissectionprinciplesofmanagement |
_version_ |
1716791944597733376 |