Modified Bentall operation in a patient with hemophilia A

We detail a successful modified Bentall operation in a patient with hemophilia A. A 53-year-old man with mild hemophilia A and a history of few bleeding episodes was diagnosed with annuloaortic ectasia. Surgical repair was planned. Simple bolus infusions of factor VIII concentrate were given before and after cardiopulmonary bypass to achieve 100% blood levels and postoperatively every 12 hours for 7 days to maintain 50% levels. The patient received no transfusion other than 10 units of platelet concentrate. We used routine operative and cardiopulmonary bypass techniques. The patient recovered well postoperatively with no excessive bleeding despite warfarin therapy.