Table 1 Summary of previously published case reports about the use of rFVIIa in patients with ventricular assist devices
Flynn et al., [4] | Kogan et al., [5] | Potapov et al., [6] | Zietkiewicz et al., [7] | |
|---|---|---|---|---|
Type of VAD | LVAD | RVAD | BIVAD | LVAD |
Blood loss before rFVIIa | 1500 mL/h | Massive bleeding | 1000 mL/h | 1000 mL/h |
Therapy before administration of rFVIIa | 11 FFP 7 PC. PPSB* | 15 FFP 16 PC. (20 units RBC) | 56 FFP 4 PC. 2000 i.U. PPSB 28 μg desmopressine protamine* aprotinine* (30 units RBC) | FFP* PC* tranexamic acid* (RBC)* |
Laboratory values before administration of rFVIIa | not reported | INR: 2,86 PTT: > 120 sec. Fib.: 115 mg/dl PLT.: 78.000/μL | INR: 1,39 PTT: 42,5 sec. Fib.: 212 mg/dl AT: 83% PLT.: 54.800/μL | INR: 1,61 AT: 62% Fib.: 271 mg/dL PLTr.: 89.000/μL |
Dose of rFVIIa | 90 μg/kg | 2 × 35 μg/kg | 120 + 60 μg/kg | 20 + 30 μg/kg |
Blood loss after rFVIIa | < 100 mL/h | 0 | < 100 mL/h | < 15 mL/h |
Laboratory values after administration of rFVIIa | not reported | INR: 1,3 PTT: 34 sec. Fib.: 127 mg/dL PLT.: 88.000/μl | INR: 1,19 PTT: 47 sec. Fib.: 144 mg/dL AT: 52% PLT.: 75.700/μL | INR: 0,89 |
Clinical course/outcome | Discharged from hospital with permanent LVAD, listed for heart transplantation | Recompensation, explantation of RVAD, discharged from hospital | No thromboembolic complications. Outcome not reported. | No thromboembolic complications. Lethal tension pneumothorax 7 days after implantation of VAD. |