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January 3, 1966

Fibrinolysis During Open Heart Surgery

JAMA. 1966;195(1):A38-A39. doi:10.1001/jama.1966.03100010022008

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Postoperative hemorrhage, which often complicates open heart surgery, may in part be due to the appearance in the blood of breakdown products of fibrin and fibrinogen, a group of Canadian investigators reports.

The evidence suggests that these breakdown products, which are known to have an anticoagulant effect, may be formed locally as the result of stasis in blood vessels or the exposure of the endocardium during the surgical procedure, Alvin Zipursky, MD, told the 18th annual meeting in Winnipeg of the Canadian Cardiovascular Society.

Previous studies of the hemorrhagic diathesis associated with open heart surgery have revealed multiple defects in the coagulation mechanism. It has been postulated that these defects arise either as the result of intravascular coagulation or are secondary to increased fibrinolytic activity during bypass.

Since it has been shown that fibrin (and fibrinogen) breakdown products occur in the blood during either of these processes, Dr. Zipursky and

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