Severe intraoperative coagulopathy following routine aortobi-iliac bypass with knitted Dacron graft

Coagulopathy associated with aortic operation is generally described in patients undergoing supraceliac aortic clamping or ruptured abdominal aortic aneurysm repair. This intraoperative complication is managed with component blood replacement and occasional use of aminocaproic acid. The presence of intraoperative coagulopathy associated with aortic reconstruction for occlusive disease is not described. We report a case of severe intraoperative coagulopathy associated with aortobi-iliac artery bypass with a knitted Dacron prosthesis. Management of this complication was accomplished with administration of blood components, aminocaproic acid and explant of the Dacron prosthesis with polytetrafluoroethylene graft placement. The possibility of fibrinolysis induced by the knitted Dacron prosthesis is suggested.