Cardiac surgery and catheterization in patients with haemophilia.
The present study summarizes the results of 12 cardiac surgical procedures performed in a carrier of Haemophilia B and in six patients with Haemophilia A at a single centre from 1979 to 1998. The median age of the patients at the time of intervention was 56 years ranging from 18 years to 73 years. The six patients with Haemophilia A ranged in severity from moderately to mildly affected. Three patients were hepatitis C antibody positive. No patients were HIV antibody or hepatitis B surface antigen positive. The cardiac procedures included cardiac catheterization (n=4), coronary artery bypass surgery (n=2), percutaneous transluminal coronary angioplasty (n=1), cardiac valve replacement (AVR n=1 and AVR/MVR n=2), and closure of an atrial septal defect and subsequent drainage of a pericardial effusion (n=1). No patients had demonstrable inhibitors at the time of surgery. Haemostasis was achieved with AHF in 10/11 procedures and high purity factor IX (Immunine) in one procedure. The initial procedures involved intermittent bolus factor therapy while more recently, AHF was administered by continuous intravenous infusion. All patients demonstrated excellent intra- and post-operative haemostasis. These results, although from a small and varied group of patients, demonstrate that cardiac surgical procedures can be performed safely in patients with Haemophilia.
MacKinlay
N
N
Haemophilia Centre, Institute of Haematology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown NSW 2050, Australia.
Taper
J
J
Renisson
F
F
Rickard
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005164:Factor IX / Q000008:administration & dosage / Q000276:immunology / Q000378:metabolism; D005169:Factor VIII / Q000008:administration & dosage / Q000276:immunology / Q000378:metabolism; D015483:HIV Antibodies / Q000097:blood; D019918:Heart Valve Prosthesis Implantation; D006467:Hemophilia A / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D002836:Hemophilia B / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D006470:Hemorrhage / Q000188:drug therapy / Q000209:etiology; D006487:Hemostasis / Q000187:drug effects; D006514:Hepatitis B Surface Antigens / Q000097:blood; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D014859:Warfarin / Q000009:adverse effects
D015483:HIV Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D007518:Isoantibodies; D014859:Warfarin; D005169:Factor VIII; D005164:Factor IX; D001241:Aspirin