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Major surgery in von Willebrand's disease
I Dokal1, A Bradshaw, A Stoneham
1Department of Haematology, Royal Postgraduate Medical School and Hammersmith Hospital, London, UK.
Clinical and Laboratory Haematology
|January 1, 1989
Summary
Bleeding time is the best practical test for monitoring cryoprecipitate dosage in patients with von Willebrand
Area of Science:
- Cardiology
- Hematology
- Orthopedic Surgery
Background:
- Von Willebrand's disease (VWD) presents unique challenges for surgical patients.
- Managing VWD requires careful consideration of coagulation factor replacement.
Observation:
- Two VWD patients underwent major surgeries: aortic valve replacement and total hip replacement.
- Close monitoring of coagulation was essential throughout the perioperative period.
Findings:
- Bleeding time proved to be the most effective clinical test for guiding cryoprecipitate dosage.
- Coagulation factor replacement in VWD shows significant inter-patient variability.
Implications:
- This highlights the importance of individualized coagulation management in VWD surgery.
- Establishing satisfactory hemostasis is critical for patient recovery and discharge.