Heparin Treatment of Disseminated Intravascular Coagulation Syndrome after Open Heart Surgery

In 6 patients with Fallot (4 cases), endocardial cushion defects (1) and annuloaortic ectasia (1), laboratory evidence of the disseminated intravascular coagulation (DIC) syndrome was found at early time after open heart surgery. Though there have been many of the etiologic factors contributing to the production of DIC following cardiopulmonary bypass, in this study polycythemia, low cardiac output or shock and sepsis in addition to a long term bypass and hemolysis due to it complicated the factors.In all patients a bleeding tendency occured. The clinical manifestations of this hemorrhagic diathesis included bleeding from venipuncture sites, petechiae, ecchymoses, hematuria, tracheobroncheal bleeding and gastrointestinal bleeding. 2 patients had peripheral vasoconstriction with peripheral cyanosis. In 2 patients renal failure was found and in one necessitated hemodialysis.All patients were done administration of heparin as well as appropriate therapy of any underlying etiologic factors. 4 of the 6 patients eventually recovered. In laboratory evidence, platelet count, prothrombin time, fibrin degradation products and thrombelastogram returned to normal levels.