What is the recommended treatment for Von Willebrand disease preoperatively?

The recommended treatment for Von Willebrand disease preoperatively is DDAVP, which is desmopressin. This medication works by stimulating the release of von Willebrand factor from endothelial cells. Von Willebrand factor is crucial for platelet adhesion during the clotting process, and patients with Von Willebrand disease have a deficiency or dysfunction of this factor. By administering DDAVP prior to surgery, the levels of von Willebrand factor can be increased, which helps to improve hemostasis and reduce the risk of excessive bleeding during the surgical procedure.

Using blood transfusions is not indicated specifically for Von Willebrand disease and would not directly address the underlying deficiency of von Willebrand factor. Factor replacement therapy could be considered in severe cases or in specific surgical situations, but it is not the frontline treatment for preparing patients for routine surgical procedures. Anticoagulants are contraindicated in patients with bleeding disorders, as they can increase the risk of bleeding rather than prevent it. Thus, DDAVP is the preferred treatment to optimize coagulation status prior to surgery in patients with Von Willebrand disease.