The authors present the diagnostic and therapeutic management in @entity548 episodes associated with cardiosurgical operations, which constitutes the policy that is employed at Department of Cardiac Surgery and Transplantology, Silesian Academy of Medicine, Zabrze, Poland. The paper also presents a compendium of information on the pathophysiology of coagulation processes, most significant from the standpoint of cardiosurgical practice. Separate issues associated with providing optimal hemostasis in @entity1 operated on using cardiopulmonary bypass are discussed, along with the effect of cardiac procedures on coagulation processes. Further, the authors present their clinical observations and experience in the utilization of the recombinant activated factor VII (NovoSeven, NovoNordisk) in two @entity1 with severe perioperative @entity548 . In the first case @entity548 was associated heart transplantation procedure in a 37-year old @entity1 , who had previously been twice subjected to operations for @entity340 . A dysfunction of two artificial valves implanted 15 years previously resulted in considerable @entity121 and an extremenally severe form of @entity299 . Two months after the heart transplant the @entity1 unfortunately died due to infectious complications. In the second @entity1 the recombinant activated factor VII was employed in an attempt at controlling severe @entity548 encountered in a 15-year old @entity1 in the course of reoperation in surgical treatment of a complex congenital @entity299 . In this case the treatment was successful. In both described @entity1 who were characterized by a high risk of surgical @entity548 , the employment of the recombinant activated factor VII led to significant improvement in coagulation system indices and the hemostatic outcome was regarded positive. The authors state that the introduction of the recombinant activated factor VII to clinical practice in a selected group of @entity1 presenting with most serious coagulation abnormalities and difficult to control perioperational @entity548 allows for improving therapeutic results and decreasing mortality in cardiac surgery @entity1 . In view of the significant economic barrier associated with a high cost of the preparation, the authors propose a consistent approach of employing at all times the classic, well-balanced hemostatic management, based primarily on extended knowledge of the pathophysiology of the clotting system and on very thorough surgical hemostasis, with the recombinant activated factor VII being reserved for exceptional situations only.

[New possibilities in the postoperative measures to prevent XXXX in cardiac surgery. Will the recombinant activated factor VII improve surgical results?].

@entity1 :: ('9606', 'Species') :: ['woman', 'patients', 'patient', 'boy'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity299 :: ('MESH:D006331', 'Disease') :: ['heart defect', 'cardiac insufficiency'] @entity340 :: ('MESH:D006349', 'Disease') :: ['valvular heart disease'] @entity121 :: ('MESH:D009135', 'Disease') :: ['heart muscle damage']
@entity548 :: (MESH:D006470,Disease) :: ['bleeding']
