Use of recombinant factor VIIa as a rescue therapy for excessive bleeding after cardiac surgery

Şahin Şenay,

Şahin Şenay¹, Hasan Karabulut¹, Fevzi Toraman², Siret Ratip³, Cem Alhan¹

¹Department of Cardiovascular Surgery, Medicine Faculty of Acıbadem University, İstanbul
²Department of Anesthesiology and Reanimation, Medicine Faculty of Acıbadem University, İstanbul
³Department of Hematology, Medicine Faculty of Acıbadem University, İstanbul

Excessive bleeding after cardiac surgery is associated with increased mortality and morbidity. Nonsurgical management includes regulation of activated clotting time, nonred cell (fresh frozen plasma, platelets, cryoprecipitate) blood product support, desmopressin, antifibrinolytics and activated recombinant factor VIIa. In this article, we report a 74-year-old male patient with atrial fibrillation who suffered from dyspnea for two months. There were no coagulation abnormalities preoperatively. The patient underwent aortic and mitral valve replacement with mechanical prosthesis, tricuspid valve annuloplasty and left atrial radiofrequency ablation for the treatment of atrial fibrillation. Recombinant factor VIIa was used for excessive postoperative bleeding, the bleeding decreased rapidly and ceased at the 4^th hour of the medication. No postoperative thromboembolic event was detected, and no clinical problem was observed in one-year follow-up.

Keywords : Cardiac surgery; excessive bleeding; recombinant FVIIa

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