Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding
An 84-year-old woman underwent soft palate resection and skin grafting with tie-over under general anesthesia. Fourteen years previously, she had undergone aortic valve replacement and coronary artery bypass grafting followed by lifelong warfarin and aspirin anticoagulation. We terminated the two dr...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Dentistry |
| Online Access: | http://dx.doi.org/10.1155/2021/8861061 |
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| author | Kenichi Sato Mami Chikuda Yoshihisa Miyamae Miwako Kan |
| author_facet | Kenichi Sato Mami Chikuda Yoshihisa Miyamae Miwako Kan |
| author_sort | Kenichi Sato |
| collection | DOAJ |
| description | An 84-year-old woman underwent soft palate resection and skin grafting with tie-over under general anesthesia. Fourteen years previously, she had undergone aortic valve replacement and coronary artery bypass grafting followed by lifelong warfarin and aspirin anticoagulation. We terminated the two drugs 8 and 6 days, respectively, before the present surgery and substituted intravenous heparin (10,000 units/day), which was terminated 6 h preoperatively. The surgery was uneventful. Heparin was restarted 2 days postoperatively but without warfarin potassium or aspirin because of postoperative soft palate bleeding, which continued for 10 days despite compression hemostasis. On day 10, she exhibited a suffocating large hemorrhagic mass, leading to cardiopulmonary arrest. Emergency consultation with medical doctors and dental anesthetists resulted in pulmonary resuscitation and tracheal intubation. After confirming spontaneous circulation/respiration, she was transferred to the intensive care unit. We now consider it essential that all medical/surgical/anesthesia specialists managing patients under anticoagulant therapy collaborate perioperatively. |
| format | Article |
| id | doaj-art-c05dde19e63547a1a3fe5b2687fbc5ae |
| institution | DOAJ |
| issn | 2090-6447 2090-6455 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Dentistry |
| spelling | doaj-art-c05dde19e63547a1a3fe5b2687fbc5ae2025-08-20T03:23:23ZengWileyCase Reports in Dentistry2090-64472090-64552021-01-01202110.1155/2021/88610618861061Cardiopulmonary Arrest with Airway Obstruction due to Postoperative BleedingKenichi Sato0Mami Chikuda1Yoshihisa Miyamae2Miwako Kan3Division of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, JapanDivision of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, JapanDivision of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, JapanDivision of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, JapanAn 84-year-old woman underwent soft palate resection and skin grafting with tie-over under general anesthesia. Fourteen years previously, she had undergone aortic valve replacement and coronary artery bypass grafting followed by lifelong warfarin and aspirin anticoagulation. We terminated the two drugs 8 and 6 days, respectively, before the present surgery and substituted intravenous heparin (10,000 units/day), which was terminated 6 h preoperatively. The surgery was uneventful. Heparin was restarted 2 days postoperatively but without warfarin potassium or aspirin because of postoperative soft palate bleeding, which continued for 10 days despite compression hemostasis. On day 10, she exhibited a suffocating large hemorrhagic mass, leading to cardiopulmonary arrest. Emergency consultation with medical doctors and dental anesthetists resulted in pulmonary resuscitation and tracheal intubation. After confirming spontaneous circulation/respiration, she was transferred to the intensive care unit. We now consider it essential that all medical/surgical/anesthesia specialists managing patients under anticoagulant therapy collaborate perioperatively.http://dx.doi.org/10.1155/2021/8861061 |
| spellingShingle | Kenichi Sato Mami Chikuda Yoshihisa Miyamae Miwako Kan Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding Case Reports in Dentistry |
| title | Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding |
| title_full | Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding |
| title_fullStr | Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding |
| title_full_unstemmed | Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding |
| title_short | Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding |
| title_sort | cardiopulmonary arrest with airway obstruction due to postoperative bleeding |
| url | http://dx.doi.org/10.1155/2021/8861061 |
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