Çocuk Sağlığı ve Hastalıkları Dergisi
2002 , Vol 45 , Num 3
Risk of thrombosis and hemorrhage in a patient with severe hemophilia A and ALCAPA syndrome: a case report
İstanbul Üniversitesi İstanbul Tıp Fakültesi 1Pediatri Uzmanı, 2Pediatri Profesörü, 3Kalp ve Damar Cerrahisi Doçenti, 4Pediatri Araştırma Görevlisi, 5Pediatri Doçenti, 6Kalp ve Damar Cerrahisi Profesörü
Angiography was planned to confirm the diagnosis in a 13-month-old boy with the presumptive diagnosis of ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery). In laboratory tests before the procedure, aPTT test was measured extremely long, and severe hemophilia A was diagnosed. With the factor VIII support, coronary angiography was done, and ALCAPA syndrome was confirmed. After the procedure, a thrombosis developed in the femoral artery but it resolved the next day following IV heparin infusion. With the Factor VIII infusion, "Takeuchi operation (intrapulmonary re-roting)" was applied, and Factor VIII was used for the next 23 days after the operation. No complication developed during the postoperative period. In the 11 months since the operation, clinical and echocardiographical findings of the patient improved successfully. The rare association of ALCAPA syndrome and hemophilia A is emphasized.
Anahtar Kelimeler :
ALCAPA sendromu, hemofili, kardiyomiyopati, kanama diyatezi, koroner, ALCAPA, hemophilia, cardiomyopathy, bleeding diathesis, coronary