An Integrated Approach to von Willebrand Disease and Surgical Myocardial Revascularization.

Cardiac surgery in patients with preexisting bleeding disorders can be a challenge. Cardiopulmonary bypass can lead to bleeding disorders, above all in patients with coagulopathy. We report the case of a 42-year-old woman, with type I von Willebrand disease, who underwent off-pump coronary artery bypass grafting. Beating heart surgery associated with an adequate replacement of von Willebrand factor and factor VIII levels were chosen to prevent bleeding disorders. Her postoperative course was uneventful and she was discharged home after 5 postoperative days.