Experience with surgery in a patient with congenital deficiency of Factor VII (SPCA, proconvertin) is presented and the pertinent literature reviewed. Factor VII deficiency is not associated with a bleeding tendency, unless levels are lower than 5 per cent of normal, as measured by a true assay. Factor VII levels between 5 and 10 per cent of normal, easily achieved by infusions of bank plasma, appear adequate for hemostasis during surgery. No replacement therapy seems necessary beyond the first postoperative day.

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