[Bleeding after cardiac surgery: the role of recombinant factor VIIa].

Abstract

Cardiac surgery carries a remarkable risk of blood loss requiring transfusion of blood products. Moreover, severe bleeding necessitating reoperation occurs in 3-5% of patients according to international studies. These patients face a significantly higher morbidity and mortality. This underscores the need for a safe and effective haemostatic therapy, which may significantly improve the outcome. Recombinant activated factor VII is approved for haemophiliacs with inhibitors and patients with thrombasthenia Glanzmann and factor VII deficiency. In the proceeding years a series of articles has been published reporting the successful and safe therapy of refractory bleeding after cardiac surgery. This review focuses at presenting the pathophysiological alterations of the haemostatic system related to the cardiopulmonary bypass. These alterations are thought to explain the high risk of bleeding after cardiopulmonary bypass. Furthermore, the use of rFVIIa in paediatric and adult cardiac surgery is reviewed and critically discussed.

• Authors: C von Heymann, C Spies, H Grubitzsch, H Schönfeld, M Sander, Th Volk
• Journal: Hamostaseologie (Hamostaseologie) Vol. 26 Issue 3 Suppl 1 Pg. S77-87 (Aug 2006) ISSN: 0720-9355 [Print] Germany
• Vernacular Title: Blutungen nach herzchirurgischen Operationen: Die Rolle des rekombinanten Faktors VIIa.
• PMID: 16953296 (Publication Type: English Abstract, Journal Article)

Chemical References

• Recombinant Proteins
• Factor VIIa

Topics

• Blood Coagulation
• Blood Transfusion
• Cardiac Surgical Procedures (adverse effects)
• Factor VIIa (therapeutic use)
• Hemorrhage (drug therapy, etiology, therapy)
• Humans
• Recombinant Proteins (therapeutic use)