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[Disseminated intravascular coagulation (DIC) after artificial valve replacement: especially tricuspid regurgitation]
1Department of Cardiovascular Surgery, Fukushima Medical College.
Insights
Patients with combined cardiac valvular disease and tricuspid regurgitation experience increased bleeding and disseminated intravascular coagulation (DIC). Gabexate mesilate treatment improved platelet counts in these DIC patients.
Area of Science:
- Cardiology
- Hematology
Context:
- Valve replacement surgery for combined cardiac valvular disease presents risks.
- Tricuspid regurgitation (TR) is a potential complicating factor.
Purpose:
- To investigate the incidence and severity of disseminated intravascular coagulation (DIC) in patients undergoing valve replacement.
- To assess the impact of tricuspid regurgitation on DIC development and bleeding.
- To evaluate the efficacy of gabexate mesilate in managing DIC.
Summary:
- Eighty patients with combined cardiac valvular disease were studied, comparing 33 with tricuspid regurgitation (TR group) to 47 without (control group).
- The TR group exhibited significantly longer operative times, greater bleeding volumes, and higher DIC scores.
- Gabexate mesilate administration was associated with improved platelet counts in patients with DIC.
Impact:
- Tricuspid regurgitation in combined cardiac valvular disease is linked to a hemorrhagic tendency and increased risk of DIC.
- Gabexate mesilate demonstrates utility in managing DIC, particularly in improving platelet levels.
Abstract:
To investigate disseminated intravascular coagulation (DIC) after valve replacement, we studied DIC score in 80 patients with combined cardiac valvular disease. Thirty-three patients with (TR group) and 47 patients without (control group) tricuspid regurgitation were compared. 1) TR group, that included patients with severe cases, showed a significantly longer operative time and greater bleeding volume (p less than 0.01). 2) The DIC score was significantly higher in TR group. Administration of gabexate mesilate to patients with DIC improved their platelet counts. These results indicate that patients with combined cardiac valvular disease with tricuspid regurgitation have a hemorrhagic tendency and are subject to DIC. Administration of gabexate mesilate is useful for DIC.