Surgery for scoliosis in congenital factor VII deficiency

W. B. Greene and C. W. McMillan

A patient with severe congenital factor VII deficiency had an anterior and posterior spine fusion for severe scoliosis. For both operations, hemostatic management was 50 units of prothrombin complex concentrate (Konyne) per kilogram of body weight before surgery and every eight hours after surgery for the first 24 hours. Subsequently, 10 mL/kg of fresh frozen plasma was given daily for five days. No bleeding problems were encountered. A treatment protocol is outlined for replacement therapy management during surgery for patients with severe factor VII deficiency. Managing hemostatic control during surgery in patients with severe factor VII deficiency is relatively easy.