A patient with massive perioperative bleeding after repeat aortic surgery for proximal aortic redissection, anastomotic disruption, and prosthetic infection after recent surgery for acute type A aortic dissection was managed with, in total, 176 units of blood products during a 25-hour operating room session. The postoperative course was completely uneventful. Enduring and continuous hemostasis with mediastinal gauze packing, volume replacement, and timely blood product substitution may overcome temporary coagulopathy in desperate surgical circumstances.
Georg Thieme Verlag KG Stuttgart · New York.