Factor VII for intractable bleeding after cardiac surgery

Introduction

Recombinant activated factor VII (rFVIIa) (NovoSeven^®; Novo Nordisk, Denmark) was developed primarily for the treatment of bleeding episodes in hemophilic patients. Little information is available on the use of rFVIIa in other situations, such as intractable postsurgical or post-traumatic bleeding. In the field of cardiac surgery, only a very few cases of treatment with rFVIIa are described. Because of the difficulty in performing randomized trials in this setting, information based on case studies is very valuable.

Methods

We studied 22 consecutive patients treated with rFVIIa due to refractory postoperative bleeding. rFVIIa was given only after all other options, including revision, to stop bleeding was failed. The amount of bleeding, the number of transfused units of red cells, platelets and other blood products were recorded both before and after administration of rFVIIa.

Results

See Table 1. In all patients, bleeding was decreased significantly. Seven of 22 patients survived and were discharged from the hospital.

Table 1 (abstract P380)

Conclusion

rFVIIa is effective in promoting hemostasis after cardiac surgery. rFVIIa should be considered as a possible treatment option in intractable bleeding treatment.