Management of massive pulmonary embolism using recombinant activated Factor VII.
Massive pulmonary embolism with concomitant intracranial haemorrhage is a condition associated with high mortality. Emergency embolectomy is indicated in those cases in which medical treatment is not possible. The case of a 65-year-old woman with massive pulmonary embolism after cranial trauma with intracranial haemorrhage and two cardiac arrests prior to surgery is described. The patient suffered a right ventricular failure requiring 6h of extracorporeal circulation. After surgery a bleeding disorder happened despite conventional treatment. The patient was transferred to the ICU with packing. Despite the recent thrombotic event recombinant activated Factor VII (70 microg/kg) was used and the bleeding controlled. No other complications occurred and she was discharged 1 month later. As far as we know this is the first time that recombinant activated Factor VII has been used after a massive pulmonary embolism.
Reyes
Guillermo
G
Department of Cardiovascular Surgery, Hospital Universitario La Princesa, c/Diego de León 62, 28006, Madrid, Spain. guillermo_reyes_copa@yahoo.es
Carrasco
Nieves
N
Muñoz
Teresa
T
Duarte
Juan
J
D000368:Aged; D003029:Coagulants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017128:Embolectomy; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000601:surgery; D011994:Recombinant Proteins / Q000627:therapeutic use
D003029:Coagulants; D011994:Recombinant Proteins; D015942:Factor VIIa