{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:18:20Z","timestamp":1779365900877,"version":"3.53.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cardiac surgery is the most challenging major invasive procedure in haemophilia. It involves the use of coagulation factor replacement, heparin therapy, antifibrinolytics, platelet antiaggregants, and is associated with surgical trauma, extracorporeal circulation, cardioplegia, and hypothermia, making it highly complex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Case presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We present our experience managing a 64-year-old patient with severe haemophilia A (SHA) without inhibitors who underwent open aortic valve replacement and reduction plasty of the dilated ascending aorta under cardiopulmonary bypass (CPB). His history included SHA complications and cardiac failure due to severe aortic regurgitation. In accordance with international guidelines, the following have been decided: surgical intervention, complex medical therapy, a rigorous multidisciplinary team approach, and accurate, proper laboratory monitoring. The biological valve was successfully implanted, and the aorta was tubularly reduced to a 35\u202fmm diameter, while maintaining its symmetry. The patient was cared for in the intensive care unit for 2\u202fdays, with CPB weaned after 1\u202fh and 20\u202fmin; he was discharged after 10\u202fdays, with a recommendation for continuous prophylaxis with FVIII, combined with fractionated heparin for 3\u202fmonths, and thereafter switched to aspirin for another 3\u202fmonths. Immediate and long-term outcomes were good, with no bleeding, thrombotic events, or other complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion\/conclusion<\/jats:title>\n                    <jats:p>Balancing conflicting hemostatic factors in a controversial biological environment was a challenging life-saving task. It required accurate, continuous lab monitoring as a key prerequisite for personalised therapy. The immediate and long-term evolution was good, free of complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1824001","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:56:02Z","timestamp":1779364562000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Successful concomitant surgical interventions for dilated ascending aorta and aortic valve insufficiency in a severe haemophilia A case"],"prefix":"10.3389","volume":"13","author":[{"given":"Cristina Emilia","family":"Ursu","sequence":"first","affiliation":[{"name":"Romanian Academy of Medical Sciences, Onco-Haematology Research Unit, Children's Emergency Hospital \u201cLouis Turcanu\u201d Timisoara, European Haemophilia Treatment Centre","place":["Timi\u0219oara, Timi\u0219, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margit","family":"Serban","sequence":"additional","affiliation":[{"name":"Romanian Academy of Medical Sciences, Onco-Haematology Research Unit, Children's Emergency Hospital \u201cLouis Turcanu\u201d Timisoara, European Haemophilia Treatment Centre","place":["Timi\u0219oara, Timi\u0219, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian","family":"Tomuleasa","sequence":"additional","affiliation":[{"name":"Department of Haematology, Research Centre for Functional Genomics and Translational Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy","place":["Cluj Napoca, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adina","family":"Traila","sequence":"additional","affiliation":[{"name":"Medical Centre for Evaluation Therapy, Medical Education and Rehabilitation of Children and Young Adults, European Haemophilia Comprehensive Care Centre","place":["Buzias, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Cioata","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Clinic and Anaesthesia and Intensive Care Clinic, Institute of Cardiovascular Diseases","place":["Timisoara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Staicu","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Clinic and Anaesthesia and Intensive Care Clinic, Institute of Cardiovascular Diseases","place":["Timisoara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delia","family":"Savescu","sequence":"additional","affiliation":[{"name":"Laboratory Department, Children's Emergency Hospital \u201cLouis Turcanu\u201d Timisoara, European Haemophilia Treatment Centre","place":["Timi\u0219oara, Timi\u0219, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora Smaranda","family":"Arghirescu","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Division of Onco-Haematology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timi\u0219oara","place":["Timi\u0219oara, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1111\/hae.13411","article-title":"A golden age for Haemophilia treatment?. 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