Treatment of a patient with factor IX deficiency (hemophilia B) with coronary bypass surgery

Scharfman, William B.; Rauch, Alan E.; Ferraris, Victor A.; Burkart, Peter

doi:10.1016/s0022-5223(19)34212-6

Cited by 20 publications

(15 citation statements)

References 4 publications

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“…This case reports the first OPCAB experience with severe hemophilia B since previous studies involved moderate or mild hemophiliac patients undergoing myocardial revascularization with CPB 1–5 . Although limited, this experience confirmed that off‐pump surgery is a safe and adequate approach for severe hemophiliacs.…”

Section: Discussionsupporting

confidence: 54%

“…Several experiences with hemophiliac patients previously reported low morbidity and mortality rates 1 . However, cardiac surgery with hemophilia remains a challenge, 2,3 with specific problems related to hemorrhagic disorders associated with a high propensity of coronary artery thrombosis following infusions of factor IX concentrate 4 …”

mentioning

confidence: 99%

“…Consequently, life expectancy increased significantly. Then, the incidence of coronary artery disease is expected to increase leading to the performance of more frequent surgical myocardial revascularizations 2–5 …”

mentioning

confidence: 99%

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Off-Pump Myocardial Revascularization in a Diabetic Patient with Severe Hemophilia B and Impaired Left Ventricular Function: Hematological and Operative Strategies

Grandmougin¹,

Delolme²,

Reynaud

et al. 2005

Journal of Cardiac Surgery

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Coronary surgery with diabetes and severe hemophilia B is a challenging situation requiring specific and adequate therapeutic considerations. We herein report the case of a 52-year-old diabetic patient with severe factor IX deficiency and impaired ventricular function, who was scheduled for myocardial revascularization because of exertional angina and recurrent myocardial infarctions following infusions of factor IX concentrate. The patient underwent a successful off-pump direct myocardial revascularization with neither hemorrhagic nor thrombotic complications. Hematological protocols and operative strategies are assessed and discussed.

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Section: Discussionsupporting

confidence: 54%

mentioning

confidence: 99%

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Off-Pump Myocardial Revascularization in a Diabetic Patient with Severe Hemophilia B and Impaired Left Ventricular Function: Hematological and Operative Strategies

Grandmougin¹,

Delolme²,

Reynaud

et al. 2005

Journal of Cardiac Surgery

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“…There are several case reports and case series of percutaneous coronary stent insertion and of cardiac surgery in patients with haemophilia A [8][9][10][11][12][13][14] and haemophilia B [11,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Some of the older reports describe perioperative haemostatic strategies that are now outdated, such as plasmapheresis with fresh frozen plasma replacement [17] and reliance on prothrombin complex concentrate [16,18,21]. A few authors employed CIs of plasma-derived FIX replacement [24,29,30] and of factor VIII replacement [11][12][13] for cardiac surgery, but in the English literature, only one used rFIX [26] and that was by bolus dosing.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Cardiac surgery in patients with haemophilia B: a case report and review of the literature

et al. 2009

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Cardiac surgery for coronary heart disease, and for calcific and degenerative valvular heart disease, will likely become more frequent with an ageing haemophilia population. Our report describes the successful management of an individual with mild haemophilia B undergoing elective aortic valve replacement using a continuous infusion of recombinant factor IX. Emphasis is placed on the multidisciplinary coordination of care required across three hospital sites to ensure an uncomplicated peri- and postoperative course. We also provide a review of the current literature on cardiac surgery in patients with haemophilia B.

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“…[23][24][25] Except for factor replacement, other hemostatic agents were rarely used as an adjuvant therapy to control blood loss. During CABG the antifibrinolytics that were given were aminocaproid acid, 9,19,22 aprotinin, 11,21 and trans-4-aminomethylcyclohexanecarboxylic acid (tranexamid acid). 10,13,17 Desmopressin (DDAVP) was given in one patient with mild hemophilia A.…”

Section: Review Of the Literaturementioning

confidence: 99%

Replacement therapy for coronary artery bypass surgery in patients with hemophilia A and B

Kanellopoulou

Nomikou

2018

J Card Surg

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There are only a few cases of patients with hemophilia A and B who have undergone coronary artery bypass surgery. High levels of replacement therapy with factor concentrate either with bolus or continuous infusion are usually required pre-operatively and during the first post-operative days in order to maintain the coagulation deficient factor levels greater than 80% of normal. Heparinization during cardiopulmonary bypass appears to be safe and intra-operative blood salvage using cell saver techniques reduce the need for transfusions.

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Treatment of a patient with factor IX deficiency (hemophilia B) with coronary bypass surgery

Cited by 20 publications

References 4 publications

Off-Pump Myocardial Revascularization in a Diabetic Patient with Severe Hemophilia B and Impaired Left Ventricular Function: Hematological and Operative Strategies

Off-Pump Myocardial Revascularization in a Diabetic Patient with Severe Hemophilia B and Impaired Left Ventricular Function: Hematological and Operative Strategies

Cardiac surgery in patients with haemophilia B: a case report and review of the literature

Replacement therapy for coronary artery bypass surgery in patients with hemophilia A and B

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