Contents
What to Know About Surgery with Von Willebrand Disease
Published: Apr 25, 2024
Surgery in patients with von Willebrand Disease (VWD) requires special considerations. This article outlines the key strategies for managing VWD during major surgical procedures.
Preparing for Surgery with VWD
For individuals with VWD, preparation for surgery involves raising VWF levels to ensure proper clotting. This is done by administering VWF concentrates intravenously before the procedure. The goal is to achieve a VWF activity level of about 100 IU/dL, checked in the recovery room to avoid delays.
Managing VWF Levels During Surgery
VWF levels are maintained above 50 IU/dL throughout the surgery using repeated infusions. The frequency of infusions, typically every 8 to 12 hours, is determined based on the patient's response and clinical picture. Continuous monitoring ensures any rapid clearance or recovery issues are promptly addressed.
Addressing Potential Complications
During surgery, complications like thrombosis may arise if factor VIII levels become excessively elevated. Careful monitoring helps prevent such risks by adjusting dosages. In some cases, continuous infusion of VWF may be necessary to manage inhibitors effectively.
Frequently Asked Questions
Levels are maintained above 50 IU/dL with repeated infusions.
The target level is about 100 IU/dL.
It helps manage rapid clearance and prevent complications.
Wrapping Up
Effective management of VWF levels is essential for safe surgical outcomes in VWD patients.
References
- Nichols WL, Hultin MB, James AH, et al. von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA). Haemophilia 2008; 14:171.
- Peyvandi F, Mamaev A, Wang JD, et al. Phase 3 study of recombinant von Willebrand factor in patients with severe von Willebrand disease who are undergoing elective surgery. J Thromb Haemost 2019; 17:52.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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