RESUMEN
There is a growing literature regarding the use of recombinant activated factor VII (rFVIIa) (NovoSeven, NovoNordisk, Copenhagen, Denmark) to control refractory hemorrhage after cardiopulmonary bypass in cardiac surgery. This supporting evidence is mostly documented as case reports on patients, of which only six involve coronary artery grafting. We present our experience of a patient undergoing coronary artery bypass grafting, who suffered an anaphylactic reaction to protamine preventing safe reversal of systemic heparinization. Subsequent management of postoperative bleeding was successfully achieved only after rFVIIa administration.
Asunto(s)
Puente de Arteria Coronaria/efectos adversos , Factor VII/uso terapéutico , Hemostasis Quirúrgica , Complicaciones Posoperatorias/tratamiento farmacológico , Hemorragia Posoperatoria/tratamiento farmacológico , Resultado del Tratamiento , Grado de Desobstrucción Vascular , Anciano , Factor VIIa , Humanos , Masculino , Hemorragia Posoperatoria/etiología , Proteínas Recombinantes/uso terapéuticoRESUMEN
Purulent pericarditis involves the whole pericardium and usually presents as an acute illness with high mortality without prompt diagnosis and treatment. Presentation as a mediastinal mass causing compression of the right ventricle (RV) and symptoms of heart failure in patients without previous cardiac surgery is very rare and only three cases have been reported up to now (English language medical literature). Clinicians should be aware of this unusual condition for prompt diagnosis and treatment to be instituted.