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Replacement therapy for coronary artery bypass surgery in patients with hemophilia A and B

There are only a few cases of patients with hemophilia A and B who have undergone coronary artery bypass surgery. High levels of replacement therapy with factor concentrate either with bolus or continuous infusion are usually required pre‐operatively and during the first post‐operative days in order to maintain the coagulation deficient factor levels greater than 80% of normal. Heparinization during cardiopulmonary bypass appears to be safe and intra‐operative blood salvage using cell saver techniques reduce the need for transfusions.