Elevated coagulation factor VIII, postoperative thrombosis and flap failure in late breast reconstruction with a free TRAM flap: A case report

Abstract

Only a few studies have sought to establish whether an underlying coagulation disorder might predispose a patient to thrombosis or coincide with flap failure in the context of free flap surgery. Here, we report a case of both intra- and postoperative arterial anastomotic thromboses and late flap failure due to venous thrombosis after late breast reconstruction with a TRAM flap, in which laboratory evaluation revealed elevated levels of coagulation factor VIII (FVIII). High FVIII concentrations have recently been cited as an independent and dose-dependent risk factor for thromboembolism.