Key result
Perioperative vWF concentrate allows safe AVR without bleeding or transfusion in von Willebrand disease.
Why the study?
Does perioperative vWF concentrate infusion prevent bleeding complications in a patient with von Willebrand disease undergoing aortic valve replacement?
Case Report (n=1)
No
Does perioperative vWF concentrate infusion prevent bleeding complications in a patient with von Willebrand disease undergoing aortic valve replacement?
Perioperative administration of vWF concentrates allowed for safe aortic valve replacement with a mechanical valve without allogeneic blood transfusion in a patient with von Willebrand disease.
May support perioperative factor replacement for safe AVR in von Willebrand disease; leaves open standardized protocols.
Von Willebrand病を合併した患者に対し大動脈弁置換術（AVR）を施行した．症例は30歳男性で，13歳時に軽度の大動脈弁閉鎖不全症（AR）を指摘されていた．当時施行した心臓カテーテル検査の際に出血傾向を認め，von Willebrand病と診断された．今回AR IV度と増悪がみられたため，手術の方針とした．手術は通常どおり体外循環下に，機械弁を用いたAVRを施行した．術前検査で第VIII因子活性の低下を認めたため，術前より凝固因子補充療法を開始し，周術期に異常出血を認めなかった．他家血輸血を必要とせず，順調な経過を得た．
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Nakashima et al. (2015) conducted a case report in von Willebrand disease and aortic regurgitation (n=1). Aortic Valve Replacement and vWF concentrates (Confact F) was evaluated on Bleeding complications and need for blood transfusion.
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