Cardiac surgery in patients with Hemophilia:is it safe?

J Cardiothorac Surg. 2020 May 8;15(1):76. doi: 10.1186/s13019-020-01123-0.

Abstract

Background: The life expectancy of hemophiliacs is similar to that of the general population. As a result, the prevalence of age-related cardiovascular diseases has increased. We present our experience with hemophilia patients who underwent cardiac surgery in our Medical Center between 2004 and 2019.

Methods: All hemophilia patients who underwent cardiac surgery were identified, and their peri-operative data evaluated retrospectively.

Results: Ten patients were identified: six with hemophilia-A, one with hemophilia-B, and three with hemophilia-C (factor XI deficiency). Cardiac procedures included ten coronary artery bypass grafts and one aortic valve replacement. Hemophilia-A and B patients were treated with factor substitution, whereas patients with factor XI deficiency were treated with fresh frozen plasma. One patient died, and one patient suffered from non-active gastrointestinal bleeding.

Conclusions: While major cardiac surgery can be performed safely on patients with hemophilia, a multidisciplinary team approach and strict postoperative monitoring are essential in order to achieve optimal results.

Keywords: Cardiac surgery; Cardiovascular disease; Factor XI deficiency; Hemophilia B; Hemophilia a.

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures* / mortality
  • Factor XI Deficiency / complications*
  • Female
  • Heart Diseases / complications
  • Heart Diseases / surgery*
  • Hemophilia A / complications*
  • Hemophilia B / complications*
  • Humans
  • Male
  • Middle Aged
  • Perioperative Care / methods
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy
  • Retrospective Studies