[HSF] (urgent) Acute dissection/Osler-weber-rendu

[Tdmartin2000 at aol.com]

OK Guys tell me what to do

elderly man with Osler-weber-rendu syndrome that has had multiple mucosal 
bleeding problems his entire life and has had over 200 u of PRBC's in his life 
that now has an acute type 1 dissection and a HCT of 23 and multiple blood 
antibodies. At present he is about 18 hrs out from his acute event, is clinically 
stable with no pain, BP in the low 100's, mild AI and no pericardial effusion. 
At present our plan is to wait at least till tomorrow in order to get enough 
compatible blood.
Questions
1. Operative results??
2. Risk of bleeding post op from GI, lungs etc?
3. Any role for medical management only?

Thanks for the prompt responses I know I will get. I have no experience with 
Osler-weber-rendu and cardiac surgery and from calling around not many do.

Tom Martin
U of Florida
Gainesville