Cardiac Surgery in Patients With Blood Disorders

被引:3
作者
Nair, Devika [1 ]
Sreejith, Nayanika [2 ]
Bhambra, Amman [1 ]
Bruce, Jonathan [1 ]
Mellor, Sophie [3 ]
Brown, Louise J. [4 ]
Harky, Amer [5 ,6 ]
机构
[1] Univ Birmingham, Coll Med & Dent Sci, Birmingham, W Midlands, England
[2] Univ Oxford, Med Sci Div, Oxford, England
[3] Sandwell Gen Hosp, Sandwell & West Birmingham NHS Trust, W Bromwich, England
[4] Cumberland Infirm, North Cumbria Integrated Care NHS Fdn Trust, Carlisle, England
[5] Liverpool Heart & Chest, Dept Cardiothorac Surg, Liverpool, Merseyside, England
[6] Alder Hey Children Hosp, Dept Cardiac Surg, Liverpool, Merseyside, England
关键词
Cardiac surgery; von Willebrand Disease; Haemophilia A; Haemophilia B; Anaemia; CORONARY-ARTERY-BYPASS; VON-WILLEBRAND-DISEASE; TRANEXAMIC ACID; OFF-PUMP; ON-PUMP; POSTOPERATIVE ANEMIA; PREOPERATIVE ANEMIA; HEMOPHILIA PATIENTS; BLEEDING DISORDERS; CELL TRANSFUSION;
D O I
10.1016/j.hlc.2021.09.013
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Blood disorders that can contribute to abnormal bleeding can have a detrimental effect during cardiac surgery. Patients who are known to have such pathologies should be investigated thoroughly and cautious measures would need to be taken when cardiac surgery is needed in this cohort. The majority of current literature for cardiac surgery in patients with von Willebrand Disease and haemophilia are case reports. Nevertheless, evidence shows that optimising factor levels pre, intra and postoperatively offers outcomes similar to that of patients without these disorders. Preoperative screening followed by appropriate iron therapy reduces mortality for patients with anaemia. In this group, haemoglobin levels can be improved postoperatively through iron supplementation. The management strategy of cardiac surgery for people with blood disorders requires a multidisciplinary approach that is highly individualised for each patient. It is essential to adequately adjust preoperative, perioperative and postoperative care to the patient's blood disorder in order to achieve outcomes similar to that of patients without blood disorders.
引用
收藏
页码:167 / 176
页数:10
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