Skip to main content

Table 4 Management consensus for individuals with hemophilia

From: Cardiac surgery in patients with Hemophilia:is it safe?

Preoperative
assessments
Classification of the disease
Multidisciplinary team: surgery should be performed in hospitals that have a hemophilia treatment center
Inhibitor measurements (Bethesda assay)
Intra-operativetreatment The factor level should be maintained above 80% at the end of surgery
Factor transfusion should be managed by an experienced hematologist in the operating room
Routine use of cell saver
Routine use of TEG to monitor coagulation, especially during the process of heparin titration
Antifibrinolytics during surgery
Tissue valve should be preferred
Maintain the factor level above 80% in the early 48 h post-operatively.
Post-operativetreatment Continues is better than bolus factor replacement
Factor measurements twice daily in the morning and evening
Factor level replacement above 50% after 48 h
Inhibitor screening if clinically indicated
Intensive physiotherapy treatment and early mobility to prevent thrombosis
Low-dose aspirin prophylaxis for life