[Intrapleural hemorrhages after the correction of acquired heart defects under hypothermia without perfusion]

The authors conducted a retrospective analysis of the case records of 757 patients who underwent correction of acquired heart valvular disease under conditions of hypothermia without perfusion. Intrapleural hemorrhage occurred in the postoperative period in 43 (5.7%) patients, in 35 of them rethoracotomy had to be performed to arrest the bleeding. In patients with aortal valvular diseases a relation was revealed between the postoperative blood loss and the patient's age, the volume of operative blood loss (reverse correlation), and total dose of protamine sulfate (direct correlation), in patients with mitral valvular diseases the postoperative blood loss was related to the volume of diuresis in the first postoperative day (direct correlation). It is concluded that defective surgical hemostasis is the main cause of intrapleural hemorrhages after correction of acquired valvular diseases of the heart under conditions of hypothermia without perfusion.