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KURT N. von KAULLA, MD; BRUCE C. PATON, MRCP, FRCS; JENS G. ROSENKRANTZ, MD; EDITH von KAULLA; SUKON WASANTAPRUEK, MD

AMA Arch Surg. 1967;94(1):107-111.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THIS preliminary report presents new information concerning the hemorrhagic diathesis which develops frequently in polycythemic, cyanotic patients with tetralogy of Fallot.¹ Practical suggestions are offered for its prevention.

Unusual and excessive bleeding during and after surgery has been noticed since the earliest patients were operated upon for cyanotic congenital heart disease.² This bleeding diathesis may become manifest during any type of surgery,³ but is particularly likely to occur in secondary cardiac operations.⁴ Although laboratory evidence of clotting deficiencies may be found in small children, severe bleeding is clinically much commoner in adolescents and adults.¹ In secondary operations, the presence of vascular adhesions and extensive subcutaneous capillaries accentuates the problem.⁴

Various attempts to define the underlying clotting disturbances have been reported.⁵ Thrombocytopenia,⁶ low activity of the prothrombin complex,⁷ and poor clot retraction⁸ have been the most frequently seen abnormalities. Abnormal thromboplastin . . . [Full Text PDF of this Article]

Author Affiliations
DENVER

From the departments of medicine (Drs. von Kaulla and Wasantapruek and Mrs. von Kaulla) and surgery (Drs. Paton and Rosenkrantz), University of Colorado Medical Center, Denver.

Footnotes
Submitted for publication Aug 22, 1966.

Reprint requests to Department of Medicine, University of Colorado Medical Center, 4200 E Ninth Ave, Denver 80220 (Dr. von Kaulla).

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