[Successful use of recombinant factor VIIa in the control of a massive bleeding in two patients with biventricular assist device (Thoratec)].
Massive bleeding is a dreaded complication of biventricular mechanical assistance implantation. Its origin is multifactorial. Blood products transfusion associated with correction of coagulopathy are sometimes insufficient. We report two cases of massive bleeding after a Thoratec biventricular assistance implantation. After surgical haemostasis failure and despite the correction of coagulation disorders, a major bleeding persisted, so these patients received a single injection of 90 microg/kg of rFVIIa. This allowed in both cases a significant reduction of the bleeding and the restoration of normal haemodynamic conditions. This treatment was not complicated by any thrombotic accident.
Fritsch
N
N
Service de réanimation de chirurgie cardiaque, hôpital du Haut-Lévèque, CHU de Bordeaux, 1, avenue de Magellan, 33600 Pessac, France.
Pouquet
O
O
Roux
B
B
Abdelmoumen
Y
Y
Janvier
G
G
D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects; D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D002305:Cardiac Tamponade / Q000601:surgery; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000601:surgery; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004630:Emergencies; D015942:Factor VIIa / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006353:Heart-Assist Devices / Q000009:adverse effects; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications; D009638:Norepinephrine / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012770:Shock, Cardiogenic / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D013916:Thrombelastography; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use
D000925:Anticoagulants; D006490:Hemostatics; D011994:Recombinant Proteins; D014148:Tranexamic Acid; D007611:Aprotinin; C103587:recombinant FVIIa; D015942:Factor VIIa; D009638:Norepinephrine