Systemic venous thrombosis after recombinant factor VIIa in the control of bleeding after cardiac surgery

• Published in: Texas Heart Institute journal Vol. 34; no. 4; pp. 485 - 488
• Main Authors: Mahmoud, Amr, Al-Ruzzeh, Sharif, McKeague, Helena, Cross, Mike
• Format: Journal Article
• Language: English
• Published: United States Texas Heart Institute 2007
• Subjects: Aged; Case Report; Coronary Artery Bypass - methods; Factor VIIa - adverse effects; Factor VIIa - therapeutic use; Fatal Outcome; Female; Humans; Jugular Veins; Postoperative Hemorrhage - drug therapy; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; Subclavian Vein; Venous Thrombosis - chemically induced; Venous Thrombosis - diagnosis; postoperative hemorrhage/drug therapy; blood loss, surgical/prevention & control; treatment failure; venous thrombosis/etiology; cardiopulmonary bypass; factor VIIa/adverse effects/therapeutic use; recombinant proteins/therapeutic use; Blood coagulation/drug effects; treatment outcome; hemostatics/adverse effects
• ISSN: 0730-2347; 0730-2347

Recombinant factor VIIa has been licensed in the United Kingdom since 1996 for the control of bleeding in hemophilic patients who are actively bleeding or are about to undergo surgery. Medical practitioners are also applying recombinant factor VIIa toward the control of bleeding in patients without hemophilia. Although the efficacy of recombinant factor VIIa has been shown in many patients, concerns have arisen about the risk of thrombotic adverse events. Herein, we report the case of a 73-year-old woman who underwent major coronary surgery and developed fatal systemic venous thrombosis after recombinant factor VIIa was used in an attempt to control her severe postoperative bleeding. We review the medical literature and discuss the risks of using recombinant factor VIIa to control severe bleeding after cardiac surgery.