Peri‐operative management of an adult patient with type 2N von Willebrand's disease scheduled for coronary artery bypass graft
Peri‐operative management of an adult patient with type 2N von Willebrand's disease scheduled for coronary artery bypass graft
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一名计划行冠状动脉搭桥术的 2N 型冯维勒布兰德病成年患者的围手术期处理
DOI：
10.1111/j.1365-2044.2007.05001.x
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发表时间：
2007
期刊：
影响因子：
10.7
通讯作者：
W. Buhre
中科院分区：
文献类型：
--
作者：
V. Gerling;J. Lahpor;W. Buhre
我们描述了一例2N型血管性血友病患者，因严重三支冠状动脉病变累及左主干，计划择期行冠状动脉旁路移植术。术前给予3000 IU凝血因子VIII/Willebrand浓缩因子（~ 40 IU）。kg−1)，随后持续输注3iu h−1 (228 iu h−1)，然后进行冠状动脉手术，并进行全肝素化和体外循环。无术中出血并发症，术后仅需1单位红细胞。给予低分子肝素和阿司匹林预防血栓，并持续输注VIII因子/血管性血友病因子浓缩物2天。血液学监测结果显示，第5-6天肝素治疗由预防性转为治疗性，第7天停用肝素治疗。
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 (∼ 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.