title: von Willebrand disease and cardiopulmonary bypass: a case report.
abstract: The anesthetic management of patients undergoing cardiac surgery on cardiopulmonary bypass can be challenging. Contact of blood with extracorporeal surfaces results in altered coagulational integrity and increased risk of bleeding. Patients with preexisting bleeding disorders are particularly vulnerable. In this article we discuss the anesthetic management of a patient with von Willebrand disease (vWD) undergoing mitral valve replacement on cardiopulmonary bypass. vWD describes a number of different von Willebrand factor disorders, associated with variable degrees of bleeding, which require an individualized approach. The extent of the surgery, the patient-specific vWD coagulopathy, and clinical indicators guided our therapy, which included desmopressin, cryoprecipitate, and vWF/Factor VIII concentrate.
authors.affiliation: University of Southern California, Keck School of Medicine Program of Nurse Anesthesia, Los Angeles, California, USA. oxanateppoe@yahoo.com
authors.forename: Oxana L
authors.initials: OL
authors.lastname: Teppone-Martin
authors.forename: Manxu
authors.initials: M
authors.lastname: Zhao
authors.forename: Teresa E
authors.initials: TE
authors.lastname: Norris
mesh_terms: D000758:Anesthesia / Q000379:methods*; D002315:Cardiopulmonary Bypass; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage; D019918:Heart Valve Prosthesis Implantation; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery; D019990:Perioperative Care; D014842:von Willebrand Diseases / Q000188:drug therapy / Q000503:physiopathology; D014841:von Willebrand Factor / Q000008:administration & dosage
chemical_list: D006490:Hemostatics; D014841:von Willebrand Factor; D003894:Deamino Arginine Vasopressin