Alterations in coagulation and fibrinolysis after surgery for aortic aneurysm.
We investigated the alterations in the coagulation and fibrinolysis systems after aortic aneurysm surgery under cardiopulmonary bypass (CPB) while using newly developed "molecular markers". Fibrinogen and antithrombin III (AT-III) decreased after surgery but returned to normal values within three days. The thrombin-antithrombin III complex (TAT) and plasmin-alpha-2-plasmin inhibitor complex (PIC) both showed increased values even preoperatively, which indicated that coagulation and fibrinolysis were activated in some patients with an aortic aneurysm. Both markers maintained a high level for at least 14 days after surgery. The fibrin degradation product (FDP) also showed an increased value before and after surgery. These results apparently showed that coagulation/fibrinolysis had already been activated in some patients and maintained such a state for at least 14 days after surgery. The relation of activated system and postoperative organ dysfunction as well as the means to suppress such activation are also discussed.
Oba
J
J
Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Shiiya
N
N
Matsui
Y
Y
Goda
T
T
Sakuma
M
M
Yasuda
K
K
D000368:Aged; D000784:Aortic Dissection / Q000097:blood / Q000601:surgery*; D000933:Antifibrinolytic Agents; D000990:Antithrombin III / Q000378:metabolism; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000097:blood / Q000601:surgery*; D001780:Blood Coagulation Tests; D002315:Cardiopulmonary Bypass; D004211:Disseminated Intravascular Coagulation / Q000097:blood*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000378:metabolism; D011183:Postoperative Complications / Q000097:blood*; D012016:Reference Values; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood*; D000979:alpha-2-Antiplasmin / Q000378:metabolism; D000511:alpha-Macroglobulins
D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; D000979:alpha-2-Antiplasmin; D000511:alpha-Macroglobulins; C024668:plasmin-alpha(2)-macroglobulin complex; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D005340:Fibrinogen; D010447:Peptide Hydrolases; D005341:Fibrinolysin