PURPOSE: To describe a case of persistent and excessive @entity548 following an aortic valve and ascending aorta replacement that was successfully managed with recombinant factor VIIa (rFVIIa). The postulated mechanisms for rFVIIa are discussed. CLINICAL FEATURES: A 75-yr-old female with no @entity1003 underwent a tissue aortic valve replacement and supracoronary ascending aorta replacement for severe @entity472 and an ascending aortic @entity439 . Following surgery, she bled in excess of 200 mL x hr(-1) despite a nearly normal platelet count and nearly normal coagulation parameters. The @entity1 was surgically re-explored twice in seven hours, and despite the presence of near normal in vitro coagulation parameters, the @entity1 continued to bleed. Multiple units of fresh frozen plasma, platelets and cryoprecipitate were administered empirically. We then administered a single 6-mg (107 microg x kg(-1)) iv dose of rFVIIa. Following the administration of rFVIIa, @entity190 decreased to a total of 440 mL over the next 12 hr. CONCLUSIONS: This case describes the use of rFVIIa for intractable @entity548 postcardiovascular surgery in the presence of nearly normal laboratory markers of coagulation. Further controlled laboratory and clinical studies are required to define the role of rFVIIa in @entity1 undergoing cardiovascular surgery.

Successful treatment using recombinant factor VIIa for severe XXXX post cardiopulmonary bypass.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity1003 :: ('MESH:D001778', 'Disease') :: ['preoperative coagulopathy'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysm'] @entity472 :: ('MESH:D001024', 'Disease') :: ['aortic stenosis']
@entity548 :: (MESH:D006470,Disease) :: ['bleeding']
