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Recombinant factor VIIa as a rescue therapy in severe haemoptysis in a patient with a Fontan circulation

Part of: Functionally Univentricular Heart

Published online by Cambridge University Press:  11 September 2017

Thomas W. Mason ,
Andrew Retter  and
Gareth J. Morgan
Thomas W. Mason
Affiliation:
Critical Care, St Thomas’ Hospital, Guys and St Thomas’ NHS foundation trust, London, United Kingdom
Andrew Retter*
Affiliation:
Critical Care, St Thomas’ Hospital, Guys and St Thomas’ NHS foundation trust, London, United Kingdom
Gareth J. Morgan
Affiliation:
Adult Congenital Cardiology, St Thomas’ Hospital, Guys and St Thomas’ NHS foundation trust, London, United Kingdom
*
Correspondence to: A. Retter, Critical Care, Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom. Tel: +020 7188 7188, ext 54509; Fax: +44 2071887345; E-mail: andrew.retter@gstt.nhs.uk
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Abstract

We describe the successful use of recombinant factor VIIa (rFVIIa) in the control of massive haemoptysis in a 17-year-old patient with a Fontan circulation. The patient was intubated and ventilated in the ICU with deteriorating gas exchange. Conventional methods to control the haemoptysis were ineffective, and rFVIIa was successfully administered as a rescue therapy. rFVIIa is a powerful pro-thrombotic agent, which is only licensed in haemophiliacs with acquired inhibitors to anticoagulation. It has been used off-license in the treatment of massive haemorrhage, although a Cochrane review did not show any significant benefit; however, it may have a role as a rescue therapy where alternatives options have been exhausted after careful risk–benefit analysis.

Keywords

FontanrFVIIafactor VIIahaemoptysis
Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 1 , January 2018 , pp. 144 - 146
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Copyright
© Cambridge University Press 2017 

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References

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