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Aortic and Mitral Valve Replacement in a Patient with Hemophilia B

Department of Thoracic and Cardiovascular Surgery
¹ Department of Hematology, Christian Medical College and Hospital, Vellore, India

For reprint information contact: Roy J Korula, MCh, Tel: 91 416 222 2102 ext 2186/2106, Fax: 91 416 223 2035, Email: roykorula{at}hotmail.com, Department of Thoracic and Cardiovascular Surgery, Christian Medical College Hospital, Vellore 632 004, India.

A 25-year-old man with factor IX deficiency had an aortic and mitral valve replacement using a 2M Starr Edwards valve in the mitral position and a 22 Medtronic valve in the aortic position under cover of factor IX concentrate. The surgical procedure and the immediate postoperative period were uneventful except for a pericardial effusion which required a pericardiostomy. He was anticoagulated with heparin in the immediate postoperative period while the factor IX concentrate was being administered. Oral anticoagulation with acenocoumarol (Acitrom^®) was started, maintaining the international normalized ratio between 1.5 and 2. He was doing well at follow-up 9 months later.