Aortic Valve Replacement in Hemophilia

A patient with classical, severe hemophilia had his aortic valve replaced with use of extracorporeal circulation. To our knowledge, this is the first such patient who has undergone an open-heart operation. He was given enough antihemophilic factor (AHF) before, during, and after operation to effect normal hemostasis. The techniques for operation and extracorporeal circulation were not altered from the usual routine. The patient recovered from operation with disappearance of the left atrioventricular failure, incipient syncope, and angina that were present preoperatively. Four months after operation, the patient died following a massive, spontaneous intracerebral hemorrhage that was not related to the surgical procedure. We believe that open-heart operations can be performed safely in hemophiliac patients.