The first case of surgical myocardial revascularization and endarterectomy of the right carotid artery in the same procedure in a patient with haemophilia A

Introduction. Haemophilia A is the most common hereditary coagulation disturbance occurring due to lack of factor VIII. It widely accepted that people with haemophilia have a reduced incidence coronary artery disease, potentially because protective effect impaired against pathogenic mechanisms acute syndrome. Case report. 53-year-old man mild [FVIII 22% (mild form: more than 5%?40% normal)] was hospitalized frequent anginal pain at rest. Selective angiography revealed severe three-vessel disease. need for urgent surgical revascularization indicated. The color duplex scan showed existence hemodynamically significant stenosis on right internal carotid artery. After consulting haematologist, cardiac surgeon, and vascular it concluded high bleeding risk, patient should undergo an endarterectomy triple aortocoronary bypass in same procedure. Procedures were performed substitution FVIII concentrate. firstly underwent Then, left mammary graft implanted anterior descending as well venous grafts first obtuse marginal posterior branch. There no complications. During revascularization, there blood transfusion, nor excessive postoperative period. discharged antithrombotic therapy (aspirin, 50 mg). Conclusion. Patients are not protected development atherosclerosis. Cardiac surgery these patients presents unique challenge medical teams securing haemostasis. Adequate VIII concentrate provides adequate haemostasis possibility treatment antiplatelet therapy.