Factor VIIa for severe cardiac surgical bleeding

Severe perioperative bleeding in cardiac surgery is multifactorial in origin. Recombinant factor VIIa (rFVIIa; Novo Nordisk, Denmark) has been used perioperatively since 1988 [1]. It promotes formation of blood clots by a range of actions. We have recently introduced it into our cardiac surgical programme for severe intractable coagulopathic bleeding.