Download PDF
Thorac Cardiovasc Surg 2005; 53(6): 389-390
DOI: 10.1055/s-2005-865687
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Successful Use of Recombinant Factor VIIa in a Patient with Intractable Bleeding During Extracorporeal Membrane Oxygenation

S. Brose1 , 2 , H. Sirbu2 , M. Engel2 , R. Kuhlen3 , R. Autschbach2
  • 1Department of Cardiac Surgery, Heart Center Dresden, University of Dresden, Dresden, Germany
  • 2Department of Cardiothoracic and Vascular Surgery, University Hospital of Aachen, Aachen, Germany
  • 3Department of Anaesthesiology, University Hospital of Aachen, Aachen, Germany
Further Information

Publication History

Received January 30, 2005

Publication Date:
28 November 2005 (online)

    Permissions and Reprints All articles of this category

Abstract

Bleeding is still the most common complication during extracorporeal membrane oxygenation (ECMO) for temporary cardio-circulatory support. We present a case of a young man suffering from intractable hemorrhage during ECMO support, who was pre-treated with glycoprotein IIb/IIIa receptor antagonist Tirofiban due to a suspicion of myocardial ischemia. After failure of conventional hemostatic means, hemostasis was achieved by the donation of recombinant Factor VIIa (rFVIIa). Aspects of bleeding control during extracorporeal circulatory support, the use of Tirofiban and rFVIIa are discussed.

Key words

Recombinant Factor VIIa - extracorporeal membrane oxygenation (ECMO) - bleeding - Tirofiban

References

  • 1 Smith C, Bellomo R, Raman J S, Matalanis G, Rosalion A, Buckmaster J, Hart G, Silvester W, Gutteridge G A, Smith B, Doolan L, Buxton B F. An extracorporeal membrane oxygenation-based approach to cardiogenic shock in older population.  Ann Thorac Surg. 2001;  71 1421-1427
    CrossrefPubMedGoogle Scholar
  • 2 Doll N, Kiaii B, Borger M, Bucerius J, Krämer K, Schmitt D V, Walther T, Mohr F W. Five-year results of 219 consecutive patients treated with Extracorporeal Membrane Oxygenation for refractory postoperative cardiogenic shock.  Ann Thorac Surg. 2004;  77 151-17l
    CrossrefPubMedGoogle Scholar
  • 3 Patrano C. for the Task Force on the Use of Antiplatelet Agents in Patients with Arteriosclerotic Cardiovascular Disease of the European Society of Cardiology . Expert consensus document on the use of antiplatelet agents.  Eur Heart J. 2004;  25 166-181
    CrossrefPubMedGoogle Scholar
  • 4 Brown D L. Deaths associated with platelet glycoprotein IIb/IIIa inhibitor treatment.  Heart. 2003;  89 535-537
    CrossrefPubMedGoogle Scholar
  • 5 Hedner U. Recombinant factor VIIa (NovoSeven) as a haemostatic agent.  Dis Mon. 2003;  49 39-48
    PubMedGoogle Scholar
  • 6 Hendricks H GD, van der Maarten J MAA, deWolf J, Waterbolk W TW, Slooff M JH, van der Meer J. An effective treatment of severe intractable bleeding after valve repair by one single dose of activated recombinant factor VII.  Anesth Analg. 2001;  93 287-289
    PubMedGoogle Scholar

S. Brose

Department for Cardiac Surgery, Heart Center Dresden, University of Dresden

Fetscherstraße 76

01307 Dresden

Germany

Phone: + 493514501609

Fax: + 49 35 14 50 17 07

Email: s.brose@herzzentrum-dresden.com

      >