Abstract
POSTOPERATIVE BLEEDING complications in cardiac surgery occur in 3% to 5% of cases.1 Complex hemostatic alterations caused by hemodilution of the priming volume, loss of coagulation factors, fibrinolysis, and platelet function defects are the main reasons for increased postoperative blood loss.2 The growing number of patients scheduled for repeated coronary revascularization are a challenge to successful surgical hemostasis. Mortality in patients with bleeding complications after cardiac surgery is 2 to 3 times higher compared with nonbleeding patients.3,4 Recombinant factor VIIa (rFVIIa) has proved its clinical effectiveness in hemophiliacs, in patients with thrombocytopenia, and in patients with congenital platelet defects.5 In cardiac surgery, rFVIIa has been used successfully in patients with massive hemorrhages after operations for congenital heart defects and heart valve replacement in whom conventional hemostatic treatment did not stop the bleeding.6,7 The mechanism of action of rFVIIa is not yet fully understood. To the authors’ knowledge, this is the first report of a patient in whom severe oozing refractory to conventional hemostatic therapy occurred after third-time coronary artery bypass graft (CABG) surgery was successfully treated by a repeated infusion of rFVIIa.
Published Version
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