title: Effects of nafamostat mesilate on coagulopathy with chronic aortic dissection.
abstract: A 65-year-old man with chronic aortic dissection experienced two massive subcutaneous hemorrhages. Laboratory data indicated disseminated intravascular coagulation, whereas a contrast computed tomographic scan revealed a dilatated aortic arch with a partial thrombosis at the false lumen. Because disseminated intravascular coagulation can be caused by chronic aortic dissection, and the aortic arch was 6 cm in diameter, we performed graft replacement from the ascending to the descending aorta in a single stage. Before graft replacement, nafamostat mesilate, a protease inhibitor, was administered and the disseminated intravascular coagulation improved. Nafamostat mesilate may be useful for managing disseminated intravascular coagulation associated with chronic aortic dissection.
authors.affiliation: Department of Cardiovascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan. k-yama@cin.medic.mie-u.ac.jp
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hisato
authors.initials: H
authors.lastname: Ito
authors.forename: Takane
authors.initials: T
authors.lastname: Hiraiwa
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001550:Benzamidines; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002908:Chronic Disease; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D017352:Echo-Planar Imaging; D005500:Follow-Up Studies; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D007610:Kallikreins / Q000037:antagonists & inhibitors; D008297:Male; D011480:Protease Inhibitors / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D001550:Benzamidines; D006146:Guanidines; D011480:Protease Inhibitors; D007610:Kallikreins; C032855:nafamostat