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Volume 9- No. 6 2021

Educated Hand Publishing LLC 
“The Science Behind the Art” 
Volume 9 - No.6 2021 

 Anesthesia eJournal - Online
ISSN 2333-2611

Page 11

Anesthetic Management of a Patient with Von Willebrand Disease 
Elaine Juch, BSN, RN, 

Affiliation:
 Texas Christian University

Grant/Financial Support: 
None

Biographical data:  
Elaine Juch is a senior RRNA at Texas Christian University in Fort Worth. She would like to acknowledge the work of Courtney 
McNeill, CRNA, preceptor for guidance during this unique case. 

KEYWORDS: Von Willebrand Disease, Type I, Bleeding, Desmopressin, Transesophageal echocardiogram 

Abstract
This case report describes an anesthesia-related issue encountered during a watchman device placement and 
transesophageal echocardiogram (TEE) where profuse perioperative esophageal bleeding ensued in a patient with 
Von Willebrand disease (VWD) Type 1.  Prolonged bleeding of mucosal surfaces is common in patients with type I 
VWD and should be considered when attempting any procedure involving bruising or trauma to the oropharynx such 
as TEE or esophagogastroduodenoscopy (EGD).1 The patient had also been taking aspirin, which can precipitate 
bleeding that may not have occurred otherwise. Patients with VWD often need a combination of multiple therapies 
to treat uncontrolled bleeding. Anesthesia providers should be aware of the risk of bleeding, premedication, and which 
medications and clotting factors to give next should desmopressin be insufficient.  

AEJ