Changes in the Hemostatic System of XXXX With  Acute Aortic Dissection Undergoing Aortic  Arch Surgery.

@entity1 @entity2002 @entity697 @entity548 @entity73 @entity1003 @entity2332
BACKGROUND: Aortic arch surgery for @entity1 with @entity697 is frequently complicated by excessive @entity548 and transfusion of allogeneic blood products. However, the physiopathology of @entity697 and surgery-induced @entity1003 has never been precisely studied. The aim of the present study is to describe the changes of the perioperative hemostatic system in @entity1 with @entity697 undergoing aortic arch surgery. METHODS: Sixty-two @entity1 undergoing emergent aortic arch surgery for Stanford type A @entity697 were enrolled in this study from January 2013 to September 2014. The hemostatic system was evaluated using standard laboratory tests, plasma @entity2002 levels, and thromboelastogragh at 5 time points: anesthesia induction (T0), lowest nasopharyngeal temperature (T1), protamine reversal (T2), 4 h after surgery (T3), and on the first postoperative day (T4). RESULTS: The study results revealed that clotting factors had a tendency to be consumed in the preoperative period. Surgery and @entity2332 resulted in a progressive reduction in clotting factors, platelet counts, and function, as well as @entity2002 concentration and function. After hemostatic therapy, although platelet counts were constantly low, clotting factors and platelet function returned to nearly preoperative levels. In contrast, @entity2002 concentration and function were still significantly lower than preoperative levels. CONCLUSIONS: The results of this prospective analysis showed that @entity697 itself activated the hemostatic system even before surgery. After hemostatic therapy, fibrin formation was more @entity73 . In this setting, we proposed that hemostatic therapy should focus on rapid and sufficient supplementation of @entity2002 . Thus, we recommend further increases in @entity2002 concentration to improve @entity1003 in @entity1 with @entity697 .
