INTRODUCTION
Hemophilia A is a rare X-linked
bleeding disorder caused by mutations in the gene that encodes factor
VIII (FVIII) with a prevalence of 1/5000 live male
births.1 Disease severity is based on FVIII levels in
the blood: the severe form is defined as a factor level < 1%
of normal, the moderate form as a factor level of 1–5%, and the mild
form as a factor level between 5% and 40%.2 Cardiac
surgery in patients with severe hemophilia remains a serious problem due
to the risk of large intra- and postoperative blood loss, absence of
evidence-based guidelines regarding factor replacement therapy, and
anticoagulation treatment after valve intervention using cardiopulmonary
bypass. Here, we report the successful, minimally invasive treatment of
mitral valve insufficiency and concomitant atrial fibrillation (AF) in a
patient with severe hemophilia A.