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Ann Thorac Surg 2007;83:707-714
© 2007 The Society of Thoracic Surgeons

Reviews

Recombinant Activated Factor VII in Cardiac Surgery: A Systematic Review

Oliver Warren, MRCS, Kaushik Mandal, MS, MRCS, Vassilis Hadjianastassiou, MD, Lisa Knowlton, BSc (Hons), Sukhmeet Panesar, BSc (Hons), Kokotsakis John, MD, Ara Darzi, FMedSci, KBE, Thanos Athanasiou, MD, PhD*

Department of BioSurgery and Surgical Technology, Imperial College Faculty of Medicine, St. Mary’s Hospital, London, United Kingdom

* Address correspondence to Dr Athanasiou, Department of BioSurgery and Surgical Technology, Imperial College Faculty of Medicine, 10th Floor QEQM Building, St. Mary’s Hospital, London, W2 1NY United Kingdom. (Email: tathan5253{at}aol.com).

Postoperative hemorrhage is a common complication in cardiac surgery, and it is associated with a considerable increase in morbidity, mortality, and cost. Recombinant activated factor VII (rFVIIa) is an emerging hemostatic agent, increasingly used in cardiac surgery. This article systematically reviews the evidence regarding the efficacy, safety, and cost of rFVIIa in this setting. Although definitive evidence from randomized controlled trials is lacking, the use of rFVIIa in patients experiencing refractory postoperative hemorrhage seems promising and relatively safe. However further research is required to definitively establish its clinical utility in the postoperative cardiac patient.




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