Figure 3. The course of the treatment. Red cell concentrate (RCC) and fresh frozen plasma (FFP) transfusions were administered from intraoperatively. After surgery, unstable circulation dynamics was continued, and continuous dose of noradrenaline was added, while platelet concentrate (PC) transfusion and tranexamic acid (TXA) were also administered in addition to RCC and FFP transfusion. Hemoglobin (Hb) and platelet (Plt) count slowly declined and prothrombin time-international normalized ratio (PT-INR) was extended (PT-INR 1.54), and then RCC, FFP, and PC transfusion and TXA were also administered. Left-lung pneumonia occurred on POD 2 and antibacterial drugs were administered [cefazolin sodium (CEZ) 2 g/day, meropenem hydrate (MEPM) 1.5 g/day, ceftriaxone sodium hydrate (CTRX) 2 g/day]. However, oxygenation suddenly became worse and a chest X-ray showed worsening permeability of the right lung field on the evening of POD 2. We decided there was exacerbation of the right hemothorax, and performed the re-operation. Although the circulation dynamics continued to be stable after the re-operation, Hb and Plt count remained low and PT-INR extension continued, and then RCC, FFP, PC transfusions, and TXA were also administered after the re-operation.