Aortic puncture

Three hours later, the patient received 21 000 units of heparin in preparation for cardiopulmonary bypass (CPB). After CPB the heparin was reversed with protamine. Forty-nine hours post-operatively, intravenous heparin was started for thrombophylaxis of the prosthetic aortic valve. Fifty-three hours post-operatively, the PICC line became clotted and 2 mg of alteplase was administered. Intense back pain and blood in the epidural catheter and around the epidural 205 puncture site were noted. The pediatric team removed... 

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