Successful use of one dose of recombinant factor VIIa to control severe bleeding after emergency aortic arch replacement in deep hypothermic circulatory arrest.

This is a single case report on the effectiveness of rFVIIa in controlling severe postoperative bleeding following repair of aortic artery dissection under conditions of cardiopulmonary bypass and deep hypothermic circulatory arrest. Bleeding did not respond to infusion of aprotinin and DDAVP, or transfusion of fresh frozen plasma and platelets, but resolved quickly after a single dose of rFVIIa 90 mcg/kg. The authors comment that rFVIIa retains activity under hypothermic conditions but not with acidosis.

– Maadh Aldouri