This is one center experience on the use of rFVIIa to treat severe postoperative bleeding following cardiac surgery after failure of conventional therapy with blood components and hemostatic agents. Bleeding was controlled in 13 of 16 patients (82%), and mortality was 25%. All the patients who did not respond to rFVIIa died with multiorgan failure. Four patients (25%) suffered with severe thrombotic complications, which may be related to presence of predisposing factors to thrombosis. RFVIIa should therefore be used cautiously in such patients only to treat intractable hemorrhage after failure of conventional therapy.

– Maadh Aldouri