Recombinant factor VIIa in the management of postoperative bleeding in patients undergoing reconstruction of ruptured abdominal aortic aneurysm
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Chair and Department of Vascular Surgery and Angiology, Medical University, Lublin, Poland
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Piotr Terlecki   

Terlecki, Chair and Department of Vascular Surgery and Angiology, Medical University, Jaczewskiego 8, 20-090 Lublin, Poland.
J Pre Clin Clin Res. 2009;3(1):58-60
Recombinant activated factor VIIa (rFVIIa) (NovoSeveNovoNordisk, Bagsvaerd, Denmark) is a well-known haemostatic agent indicated for control of bleeding in patients with severe bleeding associated with hemophilia, thrombocytopenia and disseminated intravascular coagulation. The surgical literature increasingly reports the off -licence administration of rFVIIa to arrest haemorrhage refractory in other interventions. It has been successfully used to control peri-operative bleeding in trauma, cardio-vascular and neurosurgical patients. We report 10 cases of previously healthy males, without preexisting coagulopathy, who had undergone surgical procedure because of a ruptured infrarenal aortic aneurysm. Despite the administration of red blood cell concentrate, fresh frozen plasma and platelets specimens in the peri- and post-operative period, the patients were unstable and presented non-surgical bleeding. Intravenous treatment with rFVIIa was used in two doses (37-90 μg/kg) every 2 hours. In all cases, bleeding stopped. Two patients died in the period of 72 hours after operation because of multiple organ failure, a third died one month later because of myocardial infarction. We conclude that treatment with Recombinant Activated Factor VIIa for patients undergoing AAA reconstruction complicated with non-surgical, life-threatening bleeding, seems to be effective and safe.
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