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Vascular Injury and Thrombotic Potential: A Note of Caution About Recombinant Factor VIIa

Departments of Anesthesia and Physiology, mazerd{at}smh.toronto.on.ca, Department of Surgery, University of Toronto

Howard Leong-Poi, MD, FRCPC

Department of Medicine, University of Toronto, Department of Surgery, University of Toronto

James Mahoney, MD, FRCSC

Department of Surgery, University of Toronto

David Latter, MD, FRCSC

Department of Surgery, University of Toronto

Bradley H. Strauss, MD, FRCPC

Department of Medicine, University of Toronto, Sunnybrook Health Sciences Centre, University of toronto, Keenan Research Centre, Li Ka Shing Knowledge Institute, and St Michael's Hospital, University of Toronto, Ontario, Canada

Jerome M. Teitel, MD, FRCPC

Department of Medicine, University of Toronto, Department of Surgery, University of Toronto

Postoperative hemorrhage following cardiac surgery increases morbidity, mortality, and costs. Several case reports have described the successful use of recombinant factor VIIa to decrease or stop bleeding in patients undergoing cardiac surgery. The mechanism of action of recombinant factor VIIa is thought to be increased site-specific thrombin generation by tissue factor—mediated activation of coagulation or from activated platelets. However, there have also been many reports of thrombotic complications after recombinant factor VIIa administration. Randomized clinical trials and further laboratory studies should help better clarify the efficacy, safety, cost-effectiveness, and optimal dosing of recombinant factor VIIa in the cardiac surgical setting.

Key Words: recombinant factor VIIa • surgery • cardiac surgery • thrombosis • complications

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Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 11, No. 4, 261-264 (2007)
DOI: 10.1177/1089253207311357


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Mazer, C. D. Articles by Teitel, J. M. Search for Related Content PubMed PubMed Citation Articles by Mazer, C. D. Articles by Teitel, J. M. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Heart Surgery Social Bookmarking                         What's this?