[rFVIIa administration in patient with a left ventricular assistance patient].
We report the case of a left ventricular mechanical assistance (Incor Berlinheart) in a woman that experienced a postoperative non-surgical haemorrhagic complication following a reconstructive pedicled omentoplasty for implanted materials infection. After massive substitutive therapy failure at reducing blood loss and because of an hypovolaemic shock, high dosage (70 microg/kg twice) of recombinant activated factor VII (r-VIIa) was administrated resulting in spectacular cessation of bleeding and haemodynamic restoration. Continuous repeated clinical evaluation, cardiac echography and electronic monitoring of the axial pump device characteristic did not reveal any thromboembolic accident. This observation brings some indirect arguments for safe rFVIIa treatment in this type of pathology with a high thromboembolic risk.
Tual
L
L
Service d'anesthésie-réanimation, CHU Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France. loic.tual@jvr.ap-hop-paris.fr
Kirsch
M
M
Servant
J-M
JM
Drouet
L
L
Dhonneur
G
G
D000368:Aged; D015942:Factor VIIa / Q000627:therapeutic use*; D006353:Heart-Assist Devices; D006470:Hemorrhage / Q000188:drug therapy; D006801:Humans; D008297:Male; D009852:Omentum / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy; D016459:Prosthesis-Related Infections / Q000601:surgery; D011994:Recombinant Proteins / Q000627:therapeutic use; D012769:Shock / Q000188:drug therapy; D013923:Thromboembolism / Q000150:complications
D011994:Recombinant Proteins; D015942:Factor VIIa