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Managing the Complexity of Thrombotic and Bleeding Risks: Case Report of Factor VII Deficiency and Factor V Leiden
Tharun Shyam1, Soe P Winn1, Vallabh Shet2
1Maimonides Medical Center, United States.
Abstract:
Factor VII deficiency (FVIID) is a rare autosomal dominant disorder that occurs in approximately 1 in 500,000 individuals. Paradoxically, 3-4 percent of cases of FVIID result in thrombosis. The etiology behind this clotting predilection is thought to be multifactorial, possibly due to an associated pro-coagulant mutation. We hereby describe a case of FVIID with a heterozygous Factor V Leiden mutation (FVLM) in a patient with bivalvular infective endocarditis undergoing open-heart surgery. This case highlights the complexity of managing patients with concomitant bleeding and thrombotic tendencies, especially in the context of major surgery. We recommend tailoring anticoagulation strategies on a case by case basis to manage these risks.
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