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[Coronary artery bypass with extracorporeal circulation in a patient with hemophilia B]

J G Bukowski1, J L De Brux, B Ganascia

  • 1Département d'anesthésie-réanimation chirurgicale, CHU, Angers, France.

Insights

This study demonstrates successful quadruple coronary bypass grafting in a patient with factor IX deficiency (Christmas disease). Prophylactic factor IX concentrate infusions effectively prevented excessive bleeding, ensuring a safe surgical outcome.

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Coagulation Disorders

Background:

  • Factor IX deficiency (Christmas disease) presents a significant bleeding risk for surgical patients.
  • Coronary artery disease requiring surgical intervention necessitates careful management of coagulation status.

Observation:

  • A 64-year-old patient diagnosed with factor IX deficiency was scheduled for quadruple coronary bypass grafting due to angina pectoris.
  • The patient received factor IX concentrate infusions starting preoperatively and continuing for 19 days post-surgery.

Findings:

  • The surgical procedure and cardiopulmonary bypass were performed using standard protocols without modifications for the bleeding disorder.
  • No intraoperative or postoperative hemorrhagic complications were observed, indicating effective bleeding control.

Implications:

  • This case highlights the feasibility and safety of major cardiac surgery in patients with factor IX deficiency.
  • Effective perioperative management with factor IX concentrates can mitigate bleeding risks, allowing for necessary surgical interventions.

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