Cardiac Surgery in Patients With Blood Disorders

Nair, Devika; Sreejith, Nayanika; Bhambra, Amman; Bruce, J. Mitchell; Mellor, Sophie; Brown, Louise J; Harky, Amer

doi:10.1016/j.hlc.2021.09.013

Cited by 3 publications

(4 citation statements)

References 54 publications

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“…[30][31][32] With regard to therapeutic interventions during the surgical process, we found that optimization of factor levels before, during and after surgery was essential to obtain results similar to those obtained in non-hemophiliac patients. 33 In the run-up to surgery, we decided to maintain FIX levels above 30%, while avoiding very high peaks, due to concerns about the risk of thrombosis. On the day of surgery, a higher dose was administered, following the recommendations of the WFH guidelines, to achieve FIX levels close to 80%.…”

Section: Discussionmentioning

confidence: 99%

Excellent hemostatic control during cardiac surgery in a patient with hemophilia B treated with albutrepenonacog alfa (rIX‐FP): A case report

López‐Jaime,

Fernández‐Bello,

Calavia‐Aranda

et al. 2023

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Excellent hemostatic control during cardiac surgery in a patient with hemophilia B treated with albutrepenonacog alfa (rIX‐FP): A case report

López‐Jaime,

Fernández‐Bello,

Calavia‐Aranda

et al. 2023

Clinical Case Reports

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“…Cardiac surgery requires normalization of the hemostasis before the procedure. Evidence shows that optimizing factor levels pre-, intra-, and postoperatively offers outcomes similar to those of patients without bleeding disorders [ 61 ]. Although there are no specific recommendations for cardiac surgery, the World Federation of Hemophilia recommends achieving a peak FVIII level of 80–100% preoperatively, then 60–80% for the first 1–3 days following major surgery, then 40–60% for days 4–6, then 30–50% for days 7–14 [ 62 ].…”

Section: Risk Of Developing Inhibitorsmentioning

confidence: 99%

Modern Treatment of Valvulopathies in Patients with Congenital Hemophilia

Badescu,

Badulescu,

Gheorghe

et al. 2024

Life

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Hemophiliacs can develop cardiovascular diseases, including valvulopathies of various etiologies and severities. Some require surgical treatment. Performing cardiac surgery in hemophiliacs is a challenge because they maintain an increased risk of bleeding throughout their lives. Our review shows that with a multidisciplinary team and careful planning, cardiac surgery can be safely performed in these patients. Valve repair and bioprosthetic valves should be preferred over mechanical valves to avoid life-long anticoagulation. In patients who cannot receive a bioprosthetic valve, the use of the On-X mechanical valve might be considered because it requires less intensive anticoagulation after 3 months of treatment. Antithrombotic treatment is feasible in hemophiliacs only if the coagulation factor level is kept constantly above a specific trough limit. Our review is valuable because, for the first time, the available data on the modern surgical treatment of valvular disease in hemophiliacs have been synthesized and systematized.

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“…Also, abnormal activation of the coagulation cascade from inflammation and exposure to the CPB circuit contribute to ongoing coagulation and fibrinolytic derangements 4 . Evidence‐based guidelines for management and data on the bleeding risk during cardiac transplant are limited in bleeding disorder patients 5,6 …”

Section: Introductionmentioning

confidence: 99%

“…4 Evidence-based guidelines for management and data on the bleeding risk during cardiac transplant are limited in bleeding disorder patients. 5,6 We report an infant with severe HA who underwent cardiac transplantation, describe our management strategy, and review the literature of previous cardiac transplant cases in hemophilia (Table S1).…”

Section: Introductionmentioning

confidence: 99%

Balancing anticoagulation and hemostasis in an infant with severe hemophilia A during cardiac transplantation: Review of the literature and development of a surgical protocol

Regling,

Sehgal,

Hollon

et al. 2023

Pediatric Blood & Cancer

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Hemophilia A is a disorder resulting in a deficiency of clotting factor VIII that can lead to life‐threatening bleeding. Evidence‐based guidelines for surgical interventions like cardiac surgery are limited. Anticoagulation is necessary for cardiac bypass, thus risk of bleeding in a patient with hemophilia is increased and requires careful attention to maintain hemostasis. We report the first infant with severe hemophilia A and dilated cardiomyopathy who underwent successful cardiac transplantation, and review the literature on previous cardiac transplant cases in congenital hemophilia. To ensure safe and effective management, a multidisciplinary approach was used to develop the surgical protocol for transplant.

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Cardiac Surgery in Patients With Blood Disorders

Cited by 3 publications

References 54 publications

Excellent hemostatic control during cardiac surgery in a patient with hemophilia B treated with albutrepenonacog alfa (rIX‐FP): A case report

Excellent hemostatic control during cardiac surgery in a patient with hemophilia B treated with albutrepenonacog alfa (rIX‐FP): A case report

Modern Treatment of Valvulopathies in Patients with Congenital Hemophilia

Balancing anticoagulation and hemostasis in an infant with severe hemophilia A during cardiac transplantation: Review of the literature and development of a surgical protocol

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