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The use of recombinant activated factor VII in the treatment of postoperative bleedings in children with congenital heart defects

DOI: https://doi.org/10.29296/25877305-2021-11-10
Issue: 
11
Year: 
2021

А. Kostromin(1); D. Petrushenko(1), Candidate of Medical Sciences; Professor I. Nurmeev(1, 2),
MD; E. Zainetdinova(1); L. Valiullin(1); L. Galieva(1); I. Malgina(1) (1)Children’s Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan (2)Kazan State Medical University of
the Ministry of Health of Russia

The early postoperative period of patients after the correction of congenital heart defects under cardiopulmonary bypass is accompanied by an increased risk of bleeding. There is evidence of the effectiveness of recombinant activated factor VII (rFVIIa) in the treatment of massive perioperative bleeding in children with congenital heart defects. The aim of the retrospective study was to study the experience of using rFVIIa in the treatment of hypocoagulant postoperative bleeding in children with congenital heart defects. Materials and methods. The analysis of the results of diagnostics and surgical treatment of 34 children aged 1 day to 17.5 years for congenital heart defects was carried out. The data of clinical observation and laboratory research were used. The introduction of rFVIIa was performed in the presence of severe postoperative bleeding with a blood loss rate of more than 3 ml/kg/h and signs of hypocoagulation. Results. In all patients, postoperative bleeding was stopped. In all age groups, except for the age of 3–7 years, a significant decrease in the volume of bleeding was obtained with the relative time point of rFVIIa administration. Complications and deaths were not observed. Conclusions. The use of the rFVIIa preparation is effective in the treatment of hypocoagulant postoperative bleeding in children with congenital heart defects after corrective interventions under cardiopulmonary bypass. There were no complications and side effects of the drug, which indicates the safety of therapy.

Keywords: 
children
congenital heart defects
surgery
extracorporeal circulation
bleeding
recombinant activated factor VII



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