Hemophilia and Thrombosis Unit, Department of Hematology, Vall d'Hebron University Hospital, Barcelona, Spain.
Department of Cardiology, Vall d'Hebron University Hospital, Barcelona, Spain.
J Thromb Thrombolysis. 2019 Aug;48(2):299-302. doi: 10.1007/s11239-019-01888-9.
Antithrombotic treatment and perioperative management in patients with hemophilia remains a challenge. As life expectancy in these patients is increasing, a concern about cardiovascular diseases is emerging. Herein we present the case of a 68 year-old patient with mild hemophilia B and multivessel coronary disease who underwent coronary artery bypass grafting (CABG) surgery. Off-pump surgery with continuous infusion FIX treatment was performed successfully with stable factor IX levels, and no bleeding or thrombotic complications. There is a paucity of cases reported regarding management of CABG in this population. To our knowledge, this is the first patient with mild hemophilia B that underwent CABG surgery with off-pump technique, that seems to be a secure and effective procedure.
血友病患者的抗血栓治疗和围手术期管理仍然是一个挑战。随着这些患者的预期寿命延长，对心血管疾病的担忧也在出现。本文介绍了一位 68 岁患有轻度乙型血友病和多支血管性冠状动脉疾病的患者，他接受了冠状动脉旁路移植术（CABG）。采用不停跳手术和持续输注 FIX 治疗成功完成手术，凝血因子 IX 水平稳定，无出血或血栓并发症。关于此类人群的 CABG 管理，报道的病例很少。据我们所知，这是首例接受非体外循环技术 CABG 手术的轻度乙型血友病 B 患者，该手术似乎是一种安全有效的方法。
