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Complications after bypass
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Complications after bypass


  My grandfather (age 76) had a valve replaced about six months ago.  Recently
  he was admitted to the hospital complaining of shortness of breath.
  His doctor said there is buildup of fluid in the sack surrounding his heart
  and that it would have to be drained.  He showed me the tube used to drain
  the fluid, and the stuff at the other end sure looks like blood to me.
  He has been in the hospital now over two weeks and the doctors cannot find
  the source of the blood draining.  In the meantime his platlette (spell?)
  count has dropped and the doctor said it puts him in the same situation
  as a " bleeder", which I understand to be very dangerous.
  I'm sorry details are sketchy, but the trade jargon the surgeons use leave
  me confused at best.  Any ideas about the source of fluid buildup?
  Is there any treatment to bring platlettes up?
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Dear Kevin,
Estimates of the incidence fluid accumulation around the heart following bypass surgery range from 10-40%.  Many of these cases are the result of an auto-inflammatory process known as "post-cardiotomy syndrome".  If the collection is significant, or if it is causing symptoms such a shortness of breath, it is appropriate to drain it.  Some patients with difficult cases of the problem may require gentle suppression of the immune system with medications such as prednisone.   It is usually self-limited and resolves in the vast majority of cases.  
However, there are other causes of fluid around the heart.  In fact, the list of possibilities is quite lengthy.  The specific diagnosis would hinge on the results of tests done on the fluid that was drained.  You might want to ask your doctors what they think caused this problem.  Low platelet counts can be due to a variety of causes including primary abnormalities of the bone marrow,  another auto-immune process that attacks the platelets known as ITP, and also may occur as a result of malfunction of the heart valve, resulting in physical destruction of the platelets.  An assessment of the valve's function is indicated.  
I hope your grandfather has a speedy recovery.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies should only be sought from your physician.  





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