Peri-operative management of an adult patient with type 2N von Willebrand's disease scheduled for coronary artery bypass graft.

Abstract:

:We describe a patient with type 2N von Willebrand's disease scheduled for elective coronary artery bypass graft for severe three-vessel coronary artery disease with involvement of the left main stem. He was given a pre-operative bolus of 3000 IU factor VIII/Willebrand factor concentrate (approximately 40 IU.kg(-1)), followed by a continuous infusion of 3 IU.h(-1) (228 IU.h(-1)) before undergoing coronary surgery with full heparinisation and cardiopulmonary bypass. There were no intra-operative bleeding complications and only one unit of packed red blood cells was required postoperatively. Thromboprophylaxis with low-molecular weight heparin and aspirin was given and the infusion of factor VIII/von Willebrand factor concentrate continued for 2 days. As a result of haematological monitoring, heparin therapy was changed from prophylactic to therapeutic on day 5-6 and stopped on day 7.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Gerling V,Lahpor JR,Buhre W

doi

10.1111/j.1365-2044.2007.05001.x

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

405-8

issue

4

eissn

0003-2409

issn

1365-2044

pii

ANA5001

journal_volume

62

pub_type

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