ArticleThe Annals of thoracic surgery2012
Intraoperative use of low-dose recombinant activated factor VII during thoracic aortic operations.
Article in The Annals of thoracic surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 57 citations in OpenAlex.
- Combination use of platelets and recombinant activated factor VII for increased hemostasis during acute type a dissection operations.Journal of cardiothoracic surgery · 2014Trial
- Rescue Therapy With Factor VII for Refractory Cardiac Surgical Bleeding: A Propensity-Score-Matched Study.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Intraoperative Hemostatic Agents in Thoracic Aortic Surgery-A Scoping Review.Journal of clinical medicine · 2025Review
- Successful hemostasis in refractory alveolar hemorrhage using low-dose recombinant activated factor VII.Respiratory medicine case reports · 2022Article
- Three-factor prothrombin complex concentrates for refractory bleeding after cardiovascular surgery within an algorithmic approach to haemostasis.Vox sanguinis · 2019Article
- Decoding the volume-outcome relationship in Type A aortic dissection.General thoracic and cardiovascular surgery · 2019Review
- Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement.The Journal of thoracic and cardiovascular surgery · 2016Article
- Perioperative management of the bleeding patient.British journal of anaesthesia · 2016Review
- Recombinant activated factor VII for uncontrolled bleeding postcardiac surgery.Journal of the Saudi Heart Association · 2016Article
- Comparison of low- and high-dose recombinant activated factor VII for postcardiac surgical bleeding.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2016Article
- The utility of the aortic dissection team: outcomes and insights after a decade of experience.Annals of cardiothoracic surgery · 2016Article
- Prothrombin Complex Concentrates for Bleeding in the Perioperative Setting.Anesthesia and analgesia · 2016Review
- Use of human fibrinogen concentrate during proximal aortic reconstruction with deep hypothermic circulatory arrest.The Journal of thoracic and cardiovascular surgery · 2016Article
- Recombinant Activated Factor VII Significantly Reduces Transfusion Requirements in Cardiothoracic Surgery.Drugs in R&D · 2015Article
- Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: does it matter? A propensity-matched analysis.The Journal of thoracic and cardiovascular surgery · 2014Article
- Recombinant factor VII is associated with worse survival in complex cardiac surgical patients.The Annals of thoracic surgery · 2014Article
- Outcomes of acute type a dissection repair before and after implementation of a multidisciplinary thoracic aortic surgery program.Journal of the American College of Cardiology · 2014Article
- Predictors of electrocerebral inactivity with deep hypothermia.The Journal of thoracic and cardiovascular surgery · 2014Article
- Adequacy of hemostatic resuscitation improves therapeutic efficacy of recombinant activated factor VII and reduces reexploration rate for bleeding in postoperative cardiac surgery patients with refractory hemorrhage.Annals of cardiac anaesthesiaObservational
- Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundNumerous studies have supported the effectiveness of recombinant activated factor VII (rFVIIa) for the control of bleeding after cardiac procedures; however safety concerns persist. Here we report the novel use of intraoperative low-dose rFVIIa in thoracic aortic operations, a strategy intended to improve safety by minimizing rFVIIa exposure.
methodsBetween July 2005 and December 2010, 425 consecutive patients at a single referral center underwent thoracic aortic operations with cardiopulmonary bypass (CPB); 77 of these patients received intraoperative low-dose rFVIIa (≤60 μg/kg) for severe coagulopathy after CPB. Propensity matching produced a cohort of 88 patients (44 received intraoperative low-dose rFVIIa and 44 controls) for comparison.
resultsMatched patients receiving intraoperative low-dose rFVIIa got an initial median dose of 32 μg/kg (interquartile range [IQR], 16-43 μg/kg) rFVIIa given 51 minutes (42-67 minutes) after separation from CPB. Patients receiving intraoperative low-dose rFVIIa demonstrated improved postoperative coagulation measurements (partial thromboplastin time 28.6 versus 31.5 seconds; p=0.05; international normalized ratio, 0.8 versus 1.2; p<0.0001) and received 50% fewer postoperative blood product transfusions (2.5 versus 5.0 units; p=0.05) compared with control patients. No patient receiving intraoperative low-dose rFVIIa required postoperative rFVIIa administration or reexploration for bleeding. Rates of stroke, thromboembolism, myocardial infarction, and other adverse events were equivalent between groups.
conclusionsIntraoperative low-dose rFVIIa led to improved postoperative hemostasis with no apparent increase in adverse events. Intraoperative rFVIIa administration in appropriately selected patients may correct coagulopathy early in the course of refractory blood loss and lead to improved safety through the use of smaller rFVIIa doses. Appropriately powered randomized studies are necessary to confirm the safety and efficacy of this approach.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.