- K McCusker: Jack D. Weiler Hospital of the Albert Einstein College of Medicine, Bronx, New York, USA.
Cardiac surgery requiring cardiopulmonary bypass (CPB) has increased in both number and safety over the past four decades. Postoperative bleeding continues to be a major cause of perioperative morbidity. The reported incidence varies from 4-32%. This paper reviews the preoperative evaluation and specific hemostasis defects associated with cardiac surgery and extracorporeal circulation. Monitoring of anticoagulation and coagulation, methods to decrease the alterations of the coagulation system, as well as the specific therapy for and risks of post-CPB bleeding are also discussed.