Hemorrhagic complications can result from aggressive surgical procedures in patients with congenital FVII deficiency and the hemorrhagic predisposition in affected patients is highly variable. We describe here a patient with congenital factor VII deficiency undergoing inguinal herniorraphy successfully managed with Recombinant Factor Vila (Novoseven) during surgery. Recombinant FVIIa 1200 micrograms (20 micrograms/kg) was administered preoperatively and every 6 hr for 7 days postoperatively. FVII levels measured before surgery were 6% of normal. Recombinant FVIIa was administered as an IV bolus. FVII levels were measured immediately postinfusion and 2,4 and 6 hours after doses administered on days 1 and 7. DURATION FVII LEVELS(U/dL) - DAY 1 FVII LEVELS(U/dL) - DAY 7 Range 50-150 U/dL Range 50-150 U/dL Immediately postinfusion 808 740 2 hours 148 132 4 hours 69 89 6 hours 44 26 A flexible bronchoscopy and a colonoscopy for evaluation of previous episodes of hemoptysis and melena was performed successfully during the period of postoperative FVIIa treatment with good hemostasis. No clinical or laboratory evidence of DIG or thrombocytopenia were seen. Recombinant FVIIa was well tolerated with no untoward side-effects. Recombinant FVIIa was found to be highly effective in achieving peri-operative and post-operative hemostasis in this patient with congenital FVII deficiency and at doses considerably less than that required in patients with FVII1 or FIX inhibitors.
|Original language||English (US)|
|Issue number||11 PART II|
|State||Published - Dec 1 2000|
ASJC Scopus subject areas
- Cell Biology