[Perioperative management of a patient with factor V Leiden mutation]

Although the factor V Leiden mutation had not been reported in Japan, we experienced the perioperative management of a patient with factor V Leiden mutation. A 38-year-old Caucasian woman with factor V Leiden heterozygote underwent right lobectomy for thyroid tumor under general anesthesia. The postoperative course was uneventful. Heterozygosity increases risk of venous thrombosis sevenfold. A homozygote has a 20-fold increased risk of thrombosis. Heterozygosity coupled with ingestion of oral contraceptives or pregnancy increases the risk 15-fold. Anticoagulant therapy including the use of low molecular weight heparin is considered to be appropriate for perioperative management of the patient with factor V Leiden mutation.