THE DEVELOPMENT of a hemorrhagic diathesis following an open-heart operation is a serious complication.1 Hemorrhagic disease may develop as a function of: (1) abnormalities directly related to extracorporeal circulation such as thrombocytopenia, defibrination, or fibrinolysis,2 (2) depressed coagulation factors associated with hepatic decompensation, (3) occult thrombocytopenia occurring in the setting of congestive splenomegaly or drug purpura,3 and (4) subclinical qualitative defects of platelet function. Combinations of these abnormalities may also occur.
In order to decrease the possibility of hemorrhagic complications following openheart procedures, a comprehensive coagulation study has been performed upon all adult patients at The New York Hospital-Cornell Medical Center who were candidates for open-heart surgery over the past 3½ years. Included in the comprehensive coagulation study have been the following determinations: clotting time (Lee-White), bleeding time (Duke), tourniquet test (Rumpel-Leede), clot retraction (Qualitative), platelet estimate (blood smear), platelet count (Phase), fibrinogen (Fowell), fibrinolysis (Euglobin), prothrombin
Holswade GR, Nachman RL, Killip T. Thrombocytopathies in Patients With Open-Heart SurgeryPreoperative Treatment With Corticosteroids. Arch Surg. 1967;94(3):365-369. doi:10.1001/archsurg.1967.01330090059015