Cardiac surgery in an infant hemophilia B carrier with moderate hemophilia: a case report

Introduction This is the first reported case of a female infant with moderate hemophilia B undergoing complex cardiac surgery, highlighting challenges in managing bleeding disorders in this rare clinical setting. Patient concerns and clinical findings A 4-month-old girl with Trisomy 21 was found to have moderate hemophilia B and an atrioventricular septal defect requiring surgery. Diagnosis, interventions, and outcomes Genetic testing confirmed hemophilia B. Surgery was performed successfully using extended half-life recombinant factor IX (rFIX-FP) to maintain stable coagulation. The patient experienced no excessive bleeding and recovered well. Conclusion This case demonstrates that extended half-life FIX products enable safe and effective management of moderate hemophilia B during complex cardiac surgery in infants. Individualized perioperative planning and interdisciplinary collaboration are essential for optimal outcomes.