# Use of Thromboelastography in Coronary Artery Bypass Grafting in a Patient With Factor Ⅴ Deficiency With Platelet Function Disorders: A Case Report and Literature Review

## TL;DR

A patient with factor V deficiency and platelet issues underwent heart surgery with transfusion strategies guided by thromboelastography.

## Contribution

Demonstrates the use of thromboelastography for transfusion management in rare coagulation disorders during cardiac surgery.

## Key findings

- TEG-guided transfusion strategies were successfully used in a patient with factor V deficiency and platelet dysfunction.
- Preoperative platelet concentrate transfusion improved platelet function, enabling safe surgery.
- Intraoperative and postoperative management using TEG minimized unnecessary transfusions.

## Abstract

Reports on cases of factor Ⅴ (FⅤ) deficiency complicated by platelet function disorders in patients undergoing cardiac surgery are rare, and the utilization of thromboelastography in such cases is limited. This case presents a unique case of FⅤ deficiency complicated by platelet function disorders, highlighting the significance of tailored transfusion strategies guided by thromboelastography (TEG).

A 64-year-old hemodialysis patient who was diagnosed with FⅤ deficiency 24 years prior presented for an on-pump coronary artery bypass graft. The decrease in FⅤ activity on preoperative examination was mild. Based on this finding, it was determined that preoperative fresh frozen plasma supplementation was not required. However, the case was complicated by platelet function disorders; therefore, a preoperative transfusion of platelet concentrate was performed to correct the decreased platelet function, enabling subsequent surgery. Intraoperative and postoperative transfusion strategies were guided by TEG.

This study highlights TEG-guided transfusion management as a viable option for patients with FⅤ deficiency complicated by platelet function disorders.