The Journal of Thoracic and Cardiovascular Surgery, Vol 75, 168-170, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Coagulation abnormalities in patients undergoing myocardial revascularization
R Zajtchuk, GJ Collins, GF Schuchmann, PW Holley and WR Hamaker
One hundred patients were screened for hypercoagulability preoperatively
and on the third, seventh, tenth, fourteenth, and twenty- first days
postoperatively. Patients found to have hypercoagulability were treated
with heparin, aspirin, and Coumadin. When the abnormality was present
preoperatively, treatment was continued for the duration of the patient's
life. Those patients in whom abnormalities developed postoperatively were
given anticoagulants until cardiac catheterization 6 months following their
operation. Twenty-four of the 100 patients had no coagulation abnormalities
preoperatively or postoperatively. Fifteen patients were found to have
abnormality prior to operation. Their predominant abnormality was low
antithrombin III activity. Sixty-one patients became hypercoagulable
postoperatively. Predominant abnormality in this group of patients was
increased thrombin generation and increased platelet adhesiveness.
Evaluation of patients in this study group revealed a decrease in the
incidence of pulmonary embolism, an increase in the patency of vein grafts,
and the elimination of anticoagulant therapy in 24 percent of the patients.
