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Antithrombotic treatment and perioperative management in patients with hemophilia remains a challenge. As life expectancy in these patients is increasing, a concern about cardiovascular diseases is emerging. Herein we present the case of a 68 year-old patient with mild hemophilia B and multivessel coronary disease who underwent coronary artery bypass grafting (CABG) surgery. Off-pump surgery with continuous infusion FIX treatment was performed successfully with stable factor IX levels, and no bleeding or thrombotic complications. There is a paucity of cases reported regarding management of CABG in this population. To our knowledge, this is the first patient with mild hemophilia B that underwent CABG surgery with off-pump technique, that seems to be a secure and effective procedure.


M Fernández-Caballero, M F Martinez, G Oristrell, N Palmer, A Santamaría. Off-pump technique and replacement therapy for coronary artery bypass surgery in a patient with hemophilia B. Journal of thrombosis and thrombolysis. 2019 Aug;48(2):299-302

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PMID: 31152365

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