Abstract
We appreciate the comments by De Santis and colleagues [1De Santis V. Vitale D. Tritapepe L. Pietropaoli P. Recombinant activated factor VII and cardiac surgery.Ann Thorac Surg. 2008; 86 (letter): 2025Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar] regarding our article [2Bowman L.J. Uber W.E. Stroud M.R. et al.Use of recombinant activated factor VII concentrate to control postoperative hemorrhage in complex cardiovascular surgery.Ann Thorac Surg. 2008; 85: 1669-1676Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar]. We agree that studies such as these may have significant inherent biases, and every effort, statistical or otherwise, should be made to eliminate such biases to minimize confounding of results, especially in retrospective reviews such as ours. In contrast to the propensity-matched analysis published by this group [3Tritapepe L. De Santis V. Vitale D. et al.Recombinant activated factor VII for refractory bleeding after acute aortic dissection surgery: a propensity score analysis.Crit Care Med. 2007; 35: 1685-1690Crossref PubMed Scopus (40) Google Scholar] regarding recombinant activated factor VII use for refractory bleeding after surgery for aortic dissection, the population in our series is very diverse, and as such, matching patients would have been difficult and propensity scoring likely would not have effectively eliminated inherent bias. Recombinant Activated Factor VII and Cardiac SurgeryThe Annals of Thoracic SurgeryVol. 86Issue 6PreviewWe appreciated the article by Bowman and colleagues [1]. The authors demonstrated that rescue therapy with recombinant human activated factor VII (rFVIIa) is effective in reducing transfusion requirements, correcting coagulopathy, and controlling of life-threatening bleeding in patients undergoing high-risk cardiovascular surgery. The majority of patients (94.4%) received a 90 μg/kg dose of rFVIIa. Thirty-one patients (86.1%) received only 1 dose of rFVIIa, with the majority (75%) of first-time doses given in the operating room during the operative procedure. Full-Text PDF
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