Clinical Research Directory

Inclusion Criteria: 1. Age between 18 and 80 years. 2. Undergoing elective valve repair, valve replacement or complex valvular surgery through CPB. 3. Signing of the informed consent form. 4. A combined assessment of plasma activated partial thromboplastin time (plasma-aPTT) and activated clotting time (ACT) is performed 20 minutes after heparin neutralization following CPB. We considered patients who meet the following criteria to have post-CPB coagulation factor deficiencies: (1) at least moderate bleeding, as determined using a validated bleeding severity scale; (2) a targeted ACT within ±10% of baseline; and (3) a plasma-aPTT exceeding 45 seconds or more than 1.5 times baseline. The requirement could be waived when bleeding was severe and required immediate intervention. Exclusion Criteria: 1. History of cardiac surgery. 2. Severe hepatic and renal dysfunction before surgery. 3. Coagulopathy before surgery, including inherited or acquired coagulation factor deficiencies, thrombocytopenia, platelet dysfunction and other bleeding disorders. 4. Patients undergoing emergency surgery in whom discontinuation of anticoagulant therapy was not feasible \[INR \> 1.2（or above upper normal limit）after discontinued use of warfarin; withdrawal of clopidogrel less than 5 days and low molecular weight heparin less than 12 hours before surgery, etc\]. 5. Allergy to allogeneic blood products. 6. Pregnancy. 7. Other serious diseases that may affect patient survival time, such as cancers.