Aortic Valve Replacement in Severe Factor V Deficiency and Inhibitor: Diagnostic and Management Challenges

Abstract

Factor V (FV) deficiency (F5D) is a rare hematological disorder with a variable spectrum of bleeding manifestations. Until now, no specific protocols for the management of these patients have been established. However, available literature suggests that perioperative infusion of fresh frozen plasma (FFP) may help maintain FV levels to prevent bleeding. We present the case of a 64-year-old man with previously undiagnosed severe FV deficiency and mild FV inhibitor, who underwent aortic valve replacement with no bleeding complications.

Intracranial Hematoma After Ventriculoperitoneal Shunt Placement in a Patient With Factor V Deficiency: A Rare Case Report

“…Due to the rarity of these disorders and the scant literature available on the pre-operative preparations required for intracranial surgical procedures, the patient received the recommended volume of FFP according to the literature on other surgeries with high bleeding risks [ 9 , 13 ]. The calculated volume of FFP (15 to 25 mL of FFP per kilogram of body weight) is administered a short time before the procedure (30 min), aiming for a factor V level above 20% of normal [ 8 , 9 , 13 ]. Volume overload leading to acute lung injury or acute decompensation of pre-existing heart insufficiency is a significant danger, and these patients' volume status needs to be monitored during and after surgery [ 8 ].…”