Severe factor XI deficiency (hemophilia C) is a rare coagulation disorder. A 73-year-old woman, a homozygote for factor XI deficiency, required aortic valve replacement. An initial dose of 15 U kg of factor XI concentrate was administered preoperatively and on postoperative day 3. During surgery, concentrated red cells, fresh frozen plasma, platelets, tranexamic acid, and fibrinogen were transfused. Intraoperative bleeding and total chest drainage were minimal. Postoperatively, there was no need for further transfusions and no bleeding or thrombotic complications occurred. The patient was well 16 months after surgery.

No abstract

Spontaneous coronary artery dissection constitutes a rare entity that affects mostly women, especially those less than 40 years of age. Treatment of choice is a matter of discussion. It is suggested by many that the therapeutic strategy should be individualized based on each patient's clinical and angiographic manifestations. We present the case of a young woman who underwent surgical revascularization for dissection of the left main stem by using both internal thoracic arteries. Angiographic follow-up revealed resolution of the dissection, obstruction of the right internal thoracic artery graft, and reverse flow in the left internal thoracic artery graft.

Severe haemoptysis due to infective subclavian arteritis has, to our knowledge, never been documented. We report a case of subclavian arterial vasculitis that eroded into the left lung apex, causing a large intraparenchymal mycotic pseudoaneurysm. The patient presented with high fever and blood expectoration. An emergent left lateral thoracotomy was performed. The inflamed segment of the subclavian artery was resected and continuity was restored with a reversed saphenous vein graft. The postoperative course was uneventful and the patient was discharged on the 10th postoperative day.

No abstract