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您的检索式：作者名="Sean Galvin"
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| 1 | Haemostatic management for aortic valve replacement in a patient with advanced liver disease显示文摘Redo-sternotomy and aortic valve replacement in patients with advanced liver disease is rare and associated with a prohibitive morbidity and mortality. Refractory coagulopathy is common and a consequence of intense activation of the coagulation system that can be triggered by contact of blood with the cardiopulmonary bypass circuitry, bypass-induced fibrinolysis, plate-let activation and dysfunction, haemodilution, surgical trauma, hepatic decompensation and hypothermia. Management can be further complicated by right heart dysfunction, porto-pulmonary hypertension, poor myocardial protection, and hepato-renal syndrome. Complex interactions between coagulation/fibrinolysis and systemic inflammatory response syndrome reactions like 'post-perfusion-syndrome' also compound haemostatic failure. Given the limited information available for the specific management and prevention of cardiopulmonary bypass-induced haemostatic failure, this report serves to guide the anaesthesia and medical management of future cases of a similar kind. We discuss our multimodal management of haemostatic failure using pharmacological strategies, thromboelastography, continuous cerebral and liver oximetry, and continuous cardiac output monitoring. | Laurence Weinberg Irene Kearsey Clarissa Tjoakarfa George Matalanis Sean Galvin Scott Carson Rinaldo Bellomo Larry McNicol Peter McCall | 2014 | World Journal of Clinical Cases2014，2，10： | 0 |
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