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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a 3170 g newborn with a large cavernous hemangioma at the left thigh, heart failure was evident. Echo- and angiographically a large perimembranous ventricular septal defect was found. An important a-v shunt within the hemangioma could be excluded by hemodynamic investigation and selective arteriographic examination of the vascular tumor. Thrombocytopenia present from the first day of life was only temporarily overcome by corticosteroid therapy but nevertheless consumption coagulopathy (Kasabach-Merritt-Syndrome) developed and additional therapy with heparin was necessary in order to normalize the coagulation factors. However, no regression in size of the tumor occurred over the first 8 weeks of life and a total exstirpation of the hemangioma was performed. Postoperatively no further cortison or heparin therapy was necessary. Despite vigorous medical treatment the congestive heart failure persisted. After surgical closure of the ventricular septal defect at the age of three months the infant thrived and could be discharged without pathological symptoms.
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PMID:[Cavernous hemangioma and disseminated intravascular coagulation (Kasabach-Merritt syndrome) in a newborn infant with a large ventricular septal defect]. 380 21

A case undergoing conduit procedure for tetralogy of Fallot with pulmonary atresia was complicated postoperatively by bacteremia due to non-fermentative Gram-negative rods and by disseminated intravascular coagulation. He was able to be cured without any sequela. The patient was a 16-year-old male, who had undergone Blalock-Taussig anastomosis in his infancy. The present operation was carried out as follows: ventricular septal defect was closed with a Teflon-patch and discontinuity between the right ventricle and the pulmonary artery was corrected using a Hancock's valved conduit. Two weeks after the operation, pleural effusion in the right chest cavity was shown by a chest X-ray film. On the 32nd postoperative day, high fever with chills occurred, and subsequently developed pulmonary edema, shock and hemorrhagic tendencies with petechia. Pseudomonas aeruginosa, Flavobacterium and Alcaligenes faecalis were detected by the culture of pleural effusion. The platelet count decreased to about 10,000/microliters. Carbenicillin, tobramycin and minocycline were administered for the infection, and heparin and aprotinin were used for disseminated intravascular coagulation. By these treatments for about 6 months, the patient became well and was discharged without any sequela.
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PMID:A case of bacteremia and disseminated intravascular coagulation after the conduit procedure for tetralogy of Fallot with pulmonary atresia. 712 Jun 53

We report a patient of ventricular septal defect associated with a vegetations on the tricuspid valve and a perforation of the aortic cusp caused by infective endocarditis. Antibiotics could not relieve the high fever of this patient, and disseminated intravascular coagulation caused by sepsis and two-sided heart failure developed. She underwent extended tricuspid valve excision, aortic valve replacement and VSD closure during the active stage. Post-operative antibiotic therapy was continued intravenously for 6 weeks, and orally for 3 more weeks. Although post-operative right ventriculography indicated tricuspid regurgitation and right atrium enlargement, pressure study of the right side of the heart revealed normal hemodynamics.
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PMID:[Extended tricuspid valve excision for active infective endocarditis associated with ventricular septal defect]. 828 5

Severe coagulation defects often develop in neonates undergoing cardiac surgery, both as a result of the surgical intervention, and as pre-existing defects in the hemostatic mechanisms. The following case report describes a newborn patient with complex congenital heart disease and respiratory failure whose pre-operative coagulopathy was aggressively managed prior to surgical correction. A 5-day-old, 2.5 kg child presented with interrupted aortic arch, ventricular septal defect, atrial septal defect, and patent ductus arteriosus. On admission, he was in respiratory arrest suffering from profound acidemia. In addition, the child was hypothermic (30.1 degrees C), septic (Streptococcus viridans), and coagulopathic (disseminated intravascular coagulation-DIC). The patient was immediately intubated and initial coagulation assessment revealed the following: prothrombin time (PT) 48.9 s (international normalized ratio (INR) 15.7), activated partial thromboplastin time (aPTT) >106 s, platelet count 30,000 mm(3), fibrinogen 15 mg dL(-1) and antithrombin III (AT-III) 10%. Before cardiac surgery could be performed, the patient's DIC was corrected with the administration of cryoprecipitate (15 ml), fresh frozen plasma (300 ml), and platelets (195 ml). In spite of the large transfusion of fresh frozen plasma, the AT-III activity, measured as a percentage, remained depressed at 33. Initial thromboelastographic (TEG) determination revealed an index of +2.02, and following 100 IU administration of an AT-III concentrate, declined to -2.32. Sequential TEG profiles were performed over several days, with the results used to guide both transfusion and medical therapy. The congenital heart defect correction was subsequently performed with satisfactory initial results, but the patient developed a fungal infection and expired on the 16th post-operative day. The present case describes techniques of coagulation management for a newborn with both a severe hemostatic defect and congenital heart disease.
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PMID:Pre-operative coagulopathy management of a neonate with complex congenital heart disease: a case study. 1078 72

The authors report a case of streptococcus mitis endocarditis of a ventricular septal defect in a 21 months old girl admitted for necrotic purpura of the lower limbs and a history of general ill health and pyrexia for two months. The severity of this case of endocarditis was illustrated by the importance of the vasculitis, the biological signs of infection (disseminated intravascular coagulation), and the size of the vegetation. The vegetation extended from the tricuspid valve as far as the pulmonary orifice which was partially obstructed, causing signs of right ventricular failure. The portal of entry was not found. Surgical ablation of the vegetation with tricuspid valvuloplasty was necessary after 48 hours of antibiotherapy. The outcome after one year's follow-up is good. The diagnosis of bacterial endocarditis must be considered even in very young children, especially those with congenital heart disease, and, in particular, ventricular septal defect.
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PMID:[Osler endocarditis of a ventricular septal defect in a 21-month old child]. 1085 63

We report the case of a 17 year-old girl who developed sepsis due to Methicillin-Resistant Staphyloccocus Epidermidis (MRSE) infection of Dacron patch 14 years after ventricular septal defect (VSD) closure and 4 years after pacemaker implantation. Although MRSE grew in many cultures taken and proper antibiotic regimen was administered, no improvement in patient's clinical status was observed. Disseminated intravascular coagulation and multi-organ failure developed. An operation, at which perforated Dacron VSD-patch was replaced with a new Gore-Tex one, was performed by cardiac surgery team. The patient's clinical status improved immediately after the procedure. The girl remained well 12 months after discharge.
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PMID:[Staphylococcal sepsis due to ventricular septal defect patch infection 14 years after its closure]. 2073 Jul 29