Despite a markedly prolonged aPTT, a patient with a hereditary deficiency of Factor XII is unlikely to have excessive bleeding during or after surgery.
Problems for a patient with Factor XII deficiency during surgery:
(1) thrombosis, including acute myocardial infarction
(2) inability to monitor unfractionated heparin with the aPTT or ACT. These tests are used to guide heparin anticoagulation during open heart surgery and in some other situations.
A standard protocol for managing a patient with Factor XII deficiency during surgery: is to transfuse the patient with FFP until the aPTT is normal. The aPTT or ACT can then be used to monitor heparin therapy if it is needed.
The half-life of Factor XII is approximately 50 hours.
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