Recombinant factor VIIa for life-threatening bleeding in high-risk cardiac surgery despite full-dose aprotinin.

This is a case report on using rFVIIa to control severe bleeding following orthotopic cardiac transplant with multiple previous cardiac surgeries. Bleeding was initially uncontrolled despite the use of continuous aprotinin infusion and massive blood component therapy. Bleeding slowed dramatically after administration of one dose of rFVIIa at a dose of 90 mcg/kg. Treatment was not complicated by occurrence of coagulopathy.
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– Maadh Aldouri