title: Successful graft patency after factor VIIa use for bleeding in coronary artery surgery: an unusual complication of a coronary artery bypass surgery.
abstract: There is a growing literature regarding the use of recombinant activated factor VII (rFVIIa) (NovoSeven, NovoNordisk, Copenhagen, Denmark) to control refractory hemorrhage after cardiopulmonary bypass in cardiac surgery. This supporting evidence is mostly documented as case reports on patients, of which only six involve coronary artery grafting. We present our experience of a patient undergoing coronary artery bypass grafting, who suffered an anaphylactic reaction to protamine preventing safe reversal of systemic heparinization. Subsequent management of postoperative bleeding was successfully achieved only after rFVIIa administration.
authors.affiliation: Department of Cardiothoracic Surgery, St. George's Hospital, London, United Kingdom. shajahanwahed@hotmail.com
authors.forename: Shajahan
authors.initials: S
authors.lastname: Wahed
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Karagounis
authors.forename: Gunaratnam
authors.initials: G
authors.lastname: Niranjan
authors.forename: Robin
authors.initials: R
authors.lastname: Kanagasabay
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy*; D019106:Postoperative Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome; D014654:Vascular Patency