Minimally Invasive Aortic Valve Replacement in a Patient With Severe Hemophilia A.

CARDIAC SURGERY PRESENTS a major hemostatic challenge for a multitude of reasons, particularly in patients suffering from congenital or acquired hemostatic disorders. Acknowledging that, evidence from the literature suggests that cardiac surgery can be performed safely in this patient population. 1 Rossi M. Jayaram R. Sayeed R. Do patients with haemophilia undergoing cardiac surgery have good surgical outcomes?. Cardiovasc Thorac Surg. 2011; 13: 320-331 Crossref Scopus (29) Google Scholar , 2 Tang M. Wierup P. Terp K. et al. Cardiac surgery in patients with haemophilia. Haemophilia. 2009; 15: 101-107 Crossref PubMed Scopus (48) Google Scholar Moreover, minimally invasive approaches have shown potential for reduced rates of postoperative bleeding. 3 Gilmanov D. Bevilacqua S. Murzi M. et al. Minimally invasive and conventional aortic valve replacement: a propensity score analysis. Ann Thorac Surg. 2013; 96: 837-843 Abstract Full Text Full Text PDF PubMed Scopus (124) Google Scholar The authors present the case of a patient with severe hemophilia A and severe aortic regurgitation secondary to infective endocarditis who was managed successfully with aortic valve replacement through an anterior right thoracotomy.