Coagulopathy and Bleeding Management for Aortic Dissection Surgery

In patients following aortic surgery, the prevention and treatment of bleeding requires a multimodal approach that includes targeting fibrinogen and platelet repletion, the use of anti-fibrinolytic agents, and evaluating surgical sources of bleeding. Prothrombin complex concentrates, and fibrinogen concentrates are becoming increasingly important components of treatment algorithms. With major hemorrhage, specific protocols for massive transfusion in conjunction with pharmacologic agents should be considered. Bleeding management algorithms using viscoelastic testing to guide targeted replacement are being used increasingly in complex cardiac surgical patients.