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Ann Thorac Surg 2009;88:1331-1333. doi:10.1016/j.athoracsur.2008.10.033
© 2009 The Society of Thoracic Surgeons
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Kiyohito Yamamoto
Hisato Ito
Kuniyoshi Tanaka
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Case Reports

Effects of Nafamostat Mesilate on Coagulopathy With Chronic Aortic Dissection

Kiyohito Yamamoto, MD, PhD*, Hisato Ito, MD, Takane Hiraiwa, MD, PhD, Kuniyoshi Tanaka, MD, PhD

Department of Cardiovascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan

Accepted for publication October 14, 2008.

* Address correspondence to Dr Yamamoto, Department of Cardiovascular Surgery, Hamamatsu Medical Center, 328 Tomitsuka, Naka, Hamamatsu, Shizuoka, 432-8580, Japan (Email: k-yama{at}cin.medic.mie-u.ac.jp).

A 65-year-old man with chronic aortic dissection experienced two massive subcutaneous hemorrhages. Laboratory data indicated disseminated intravascular coagulation, whereas a contrast computed tomographic scan revealed a dilatated aortic arch with a partial thrombosis at the false lumen. Because disseminated intravascular coagulation can be caused by chronic aortic dissection, and the aortic arch was 6 cm in diameter, we performed graft replacement from the ascending to the descending aorta in a single stage. Before graft replacement, nafamostat mesilate, a protease inhibitor, was administered and the disseminated intravascular coagulation improved. Nafamostat mesilate may be useful for managing disseminated intravascular coagulation associated with chronic aortic dissection.






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