Elective cardiac operation in a patient with severe hemophilia and acquired factor VIII antibodies

Pl, Leggett; Doyle, Daniel; Smith, William B.; Culpepper, Walter S.; Cooper, Simon; Jl, Ochsner

doi:10.1016/s0022-5223(19)37357-x

Cited by 22 publications

(7 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current English literature contains a number of case reports, describing a variety of cardiac surgical procedures in individuals with Haemophilia A and B [ 11–15]. Our data, describing 12 procedures performed in six patients, is the largest single institution series reporting cardiac catheterization and surgical experience in patients with Haemophilia.…”

Section: Discussionmentioning

confidence: 99%

Cardiac surgery and catheterization in patients with Haemophilia

et al. 2000

View full text Add to dashboard Cite

The present study summarizes the results of 12 cardiac surgical procedures performed in a carrier of Haemophilia B and in six patients with Haemophilia A at a single centre from 1979 to 1998. The median age of the patients at the time of intervention was 56 years ranging from 18 years to 73 years. The six patients with Haemophilia A ranged in severity from moderately to mildly affected. Three patients were hepatitis C antibody positive. No patients were HIV antibody or hepatitis B surface antigen positive. The cardiac procedures included cardiac catheterization (n=4), coronary artery bypass surgery (n=2), percutaneous transluminal coronary angioplasty (n=1), cardiac valve replacement (AVR n=1 and AVR/MVR n=2), and closure of an atrial septal defect and subsequent drainage of a pericardial effusion (n=1). No patients had demonstrable inhibitors at the time of surgery. Haemostasis was achieved with AHF in 10/11 procedures and high purity factor IX (Immunine) in one procedure. The initial procedures involved intermittent bolus factor therapy while more recently, AHF was administered by continuous intravenous infusion. All patients demonstrated excellent intra- and post-operative haemostasis. These results, although from a small and varied group of patients, demonstrate that cardiac surgical procedures can be performed safely in patients with Haemophilia.

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiac surgery and catheterization in patients with Haemophilia

et al. 2000

View full text Add to dashboard Cite

show abstract

“…The only other patient with haemophilia and a high‐titre inhibitor reported to have undergone a heart transplant was an adolescent treated similarly to our patient except for the postanamnaesis use of aPCCs instead of rFVIIa [11]. In one additional published case of cardiac surgery for congenital heart disease in a haemophilia A patient with an inhibitor, high‐dose FVIII followed by the use of an aPCC provided adequate haemostasis [19]. Both individuals also survived without major morbidity.…”

Section: Discussionmentioning

confidence: 99%

Heart transplant in a factor VIII‐deficient patient with a high‐titre inhibitor: perioperative management using high‐dose continuous infusion factor VIII and recombinant factor VIIa

et al. 2001

View full text Add to dashboard Cite

Four years prior to transplantation, a 14-year-old boy with severe haemophilia A and a high-responding factor VIII (FVIII) inhibitor developed an anteroseptal myocardial infarct while receiving high doses of an activated prothrombin complex concentrate (PCC). Cardiac transplantation was required for survival because of the ensuing cardiomyopathy. At surgery, the patient's inhibitor titre was 1.8 Bethesda units (BU). High-dose bolus therapy, followed by a continuous infusion of FVIII provided excellent operative and initial postoperative haemostasis without additional blood-product support. Once anamnaesis developed on day 6 postoperatively, recombinant factor VIIa (rFVIIa) therapy was initiated. Haemostasis remained excellent, except for the transient increase in chest-tube bleeding that was noted on day 7. epsilon-Aminocaproic acid was added and haemostasis was re-established. On day 15, rFVIIa was replaced with alternate day infusions of prothrombin complex concentrates (PCCs). On day 21 following the transplant, the patient was discharged, remaining on daily FVIII immune tolerance and thrice-weekly PCC prophylaxis. He remains well 24 months after transplant with an inhibitor titre of 39 BU. This paper describes the second case of cardiac transplantation complicated by haemophilia and an inhibitor, and discusses preoperative planning and operative and postsurgical haemostasis management.

show abstract

“…Various cardiac surgical procedures have been documented in patients with hemophilia A or B, [2][3][4] but none have described management of a patient with hemophilia B undergoing double valve replacement.…”

Section: Discussionmentioning

confidence: 99%

Aortic and Mitral Valve Replacement in a Patient with Hemophilia B

Thankachen

George

Shukla

et al. 2007

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

A 25-year-old man with factor IX deficiency had an aortic and mitral valve replacement using a 2M Starr Edwards valve in the mitral position and a 22 Medtronic valve in the aortic position under cover of factor IX concentrate. The surgical procedure and the immediate postoperative period were uneventful except for a pericardial effusion which required a pericardiostomy. He was anticoagulated with heparin in the immediate postoperative period while the factor IX concentrate was being administered. Oral anticoagulation with acenocoumarol (Acitrom) was started, maintaining the international normalized ratio between 1.5 and 2. He was doing well at follow-up 9 months later.

show abstract

Elective cardiac operation in a patient with severe hemophilia and acquired factor VIII antibodies

Cited by 22 publications

References 42 publications

Cardiac surgery and catheterization in patients with Haemophilia

Cardiac surgery and catheterization in patients with Haemophilia

Heart transplant in a factor VIII‐deficient patient with a high‐titre inhibitor: perioperative management using high‐dose continuous infusion factor VIII and recombinant factor VIIa

Aortic and Mitral Valve Replacement in a Patient with Hemophilia B

Contact Info

Product

Resources

About