| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2005;80:66-71
© 2005 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Helsinki University Hospital, Helsinki, Finland
b Department of Anesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland
Accepted for publication February 15, 2005.
* Address reprint requests to Dr Raivio, Department of Cardiothoracic Surgery, Helsinki University Hospital, Haartmaninkatu 4, FIN-00029 HUS, Helsinki, Finland (Email: peter.raivio{at}hus.fi).
BACKGROUND: A generalized coagulation disorder after cardiac surgery that is associated with massive postoperative hemorrhage is not completely understood. Recombinant factor VIIa (rFVIIa) has emerged as a possible "salvage" medication. Limited experience reported in the literature and fears of possible thromboembolic complications make the use of rFVIIa in the treatment of bleeding after cardiac surgery controversial.
METHODS: We analyzed retrospectively all consecutive cardiac surgical patients who have received rFVIIa in the Helsinki University Hospital in order to evaluate the safety and efficacy of rFVIIa after cardiac surgery in our institution. Altogether, 16 patients were identified from operating room and intensive care unit (ICU) databases. Patient records and operating room and ICU databases were reviewed.
RESULTS: In this series of high risk patients hospital mortality was high (25%). A definite hemostatic effect was seen after rFVIIa administration in all but three patients (82%). Mean amount of bleeding and amount of platelet and fresh frozen plasma transfusions decreased significantly after rFVIIa administration. Four patients had serious postoperative thromboembolic complications.
CONCLUSIONS: Recombinant factor VIIa was effective in restoring hemostasis, but thromboembolic complications occurred after rFVIIa use. They may be related to the underlying pathologies and surgery performed. It is possible, however, that rFVIIa treatment contributed to their occurrence.
This article has been cited by other articles:
|
|
 |
|
  J. Tatoulis, S. Theodore, M. Meswani, R. Wynne, C. Hon-Yap, and N. Powar Safe use of recombinant activated factor VIIa for recalcitrant postoperative haemorrhage in cardiac surgery Interactive CardioVascular and Thoracic Surgery, September 1, 2009; 9(3): 459 - 462. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Gill, M. Herbertson, A. Vuylsteke, P. S. Olsen, C. von Heymann, M. Mythen, F. Sellke, F. Booth, and T. A. Schmidt Safety and Efficacy of Recombinant Activated Factor VII: A Randomized Placebo-Controlled Trial in the Setting of Bleeding After Cardiac Surgery Circulation, July 7, 2009; 120(1): 21 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Alten, K. Benner, K. Green, B. Toole, N. M. Tofil, and M. K. Winkler Pediatric Off-label Use of Recombinant Factor VIIa Pediatrics, March 1, 2009; 123(3): 1066 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. S. Avlonitis, R. W. Bury, A. J. Duncan, and J. Zacharias Penetrating ulcer of the aortic arch presenting with hemoptysis. J. Thorac. Cardiovasc. Surg., January 1, 2009; 137(1): e10 - e12. [Full Text] [PDF]
|
|
|
|
|
|
P. Narayan, C. A. Rogers, I. Davies, G. D. Angelini, and A. J. Bryan Type A aortic dissection: Has surgical outcome improved with time? J. Thorac. Cardiovasc. Surg., November 1, 2008; 136(5): 1172 - 1177. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. J. Bowman, W. E. Uber, M. R. Stroud, L. R. Christiansen, J. Lazarchick, A. J. Crumbley III, J. M. Kratz, J. M. Toole, F. A. Crawford Jr, and J. S. Ikonomidis Use of Recombinant Activated Factor VII Concentrate to Control Postoperative Hemorrhage in Complex Cardiovascular Surgery Ann. Thorac. Surg., May 1, 2008; 85(5): 1669 - 1677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Dunkley, L. Phillips, P. McCall, J. Brereton, R. Lindeman, G. Jankelowitz, and P. Cameron Recombinant Activated Factor VII in Cardiac Surgery: Experience From the Australian and New Zealand Haemostasis Registry Ann. Thorac. Surg., March 1, 2008; 85(3): 836 - 844. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Ranucci, G. Isgro, G. Soro, D. Conti, and B. De Toffol Efficacy and Safety of Recombinant Activated Factor VII in Major Surgical Procedures: Systematic Review and Meta-analysis of Randomized Clinical Trials Arch Surg, March 1, 2008; 143(3): 296 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Gelsomino, R. Lorusso, S. Romagnoli, S. Bevilacqua, G. De Cicco, G. Bille, P. Stefano, and G. F. Gensini Treatment of refractory bleeding after cardiac operations with low-dose recombinant activated factor VII (NovoSeven(R)): a propensity score analysis Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 64 - 71. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Y. Lee, W. J. DeBois, K. H. Krieger, and O. W. Isom Transfusion Therapy and Blood Conservation Card. Surg. Adult, January 1, 2008; 3(2008): 415 - 430. [Full Text]
|
|
|
|
 |
|
 C. D. Mazer, H. Leong-Poi, J. Mahoney, D. Latter, B. H. Strauss, and J. M. Teitel Vascular Injury and Thrombotic Potential: A Note of Caution About Recombinant Factor VIIa Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2007; 11(4): 261 - 264. [Abstract] [PDF]
|
|
|
|
 |
|
 S. J. Johnson, M. B. Ross, and K. G. Moores Dosing factor VIIa (recombinant) in nonhemophiliac patients with bleeding after cardiac surgery Am. J. Health Syst. Pharm., September 1, 2007; 64(17): 1808 - 1812. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al. Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline Ann. Thorac. Surg., May 1, 2007; 83(5_Supplement): S27 - S86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Warren, K. Mandal, V. Hadjianastassiou, L. Knowlton, S. Panesar, K. John, A. Darzi, and T. Athanasiou Recombinant Activated Factor VII in Cardiac Surgery: A Systematic Review Ann. Thorac. Surg., February 1, 2007; 83(2): 707 - 714. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Filsoufi, J. G. Castillo, P. B. Rahmanian, C. Scurlock, G. Fischer, and D. H. Adams Effective Management of Refractory Postcardiotomy Bleeding With the Use of Recombinant Activated Factor VII Ann. Thorac. Surg., November 1, 2006; 82(5): 1779 - 1783. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Despotis, M. Avidan, and D. M. Lublin Off-Label Use of Recombinant Factor VIIA Concentrates After Cardiac Surgery Ann. Thorac. Surg., July 1, 2005; 80(1): 3 - 5. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
