This chapter discussed cardiac bypass—origin of coagulation defects, preparing the patient for surgery, and management of bleeding. Issues with ventricular assist devices will also be discussed. More than 100,000 patients undergo cardiopulmonary bypass surgery each year. Patients presenting for cardiac surgery may have a preexisting bleeding defects or may develop severe defects during or after surgery. Increasingly over the past decade more patients are having ventricular assist devices implanted either as a bridge to cardiac transplant or permanently to improved cardiac function.
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