Abstract：
BACKGROUND: Bleeding after surgery on the thoracic aorta is a frequent complication, and can be associated with a significant increase in morbidity and mortality. Recombinant activated factor VII (rFVIIa) was developed initially for treating patients with hemophilia; however, it has been used increasingly \"off-label\" to achieve hemostasis after thoracic aortic procedures.
OBJECTIVE: This scoping review aimed to present the available literature on the role of rFVIIa in the management of refractory postoperative bleeding after thoracic aortic surgery.
RESULTS: An electronic database search was conducted using Medline, Embase, Cochrane Library, and Google Scholar in June 2023. The authors included studies that reported the use of rFVIIa in patients undergoing surgical repair of ascending or descending aortic aneurysm or dissection. Single-case reports were excluded. Ten publications with a pooled number of 649 patients (319 patients received rFVIIa and 330 in the control groups) were identified: 3 case series, 6 retrospective studies, and 1 nonrandomized clinical trial. All studies reported the potential role of rFVIIa in correcting coagulopathy and reducing postoperative blood loss in this group of patients. Overall, there was not enough evidence to suggest that rFVIIa was associated with higher rates of thromboembolic complications or mortality.
CONCLUSIONS: Limited evidence suggests that rFVIIa may be useful in managing postoperative refractory bleeding in patients undergoing thoracic aortic surgery. However, the impact of rFVIIa on thromboembolic complications and mortality rates remains unclear.
OBJECTIVE: This scoping review aimed to present the available literature on the role of rFVIIa in the management of refractory postoperative bleeding after thoracic aortic surgery.
RESULTS: An electronic database search was conducted using Medline, Embase, Cochrane Library, and Google Scholar in June 2023. The authors included studies that reported the use of rFVIIa in patients undergoing surgical repair of ascending or descending aortic aneurysm or dissection. Single-case reports were excluded. Ten publications with a pooled number of 649 patients (319 patients received rFVIIa and 330 in the control groups) were identified: 3 case series, 6 retrospective studies, and 1 nonrandomized clinical trial. All studies reported the potential role of rFVIIa in correcting coagulopathy and reducing postoperative blood loss in this group of patients. Overall, there was not enough evidence to suggest that rFVIIa was associated with higher rates of thromboembolic complications or mortality.
CONCLUSIONS: Limited evidence suggests that rFVIIa may be useful in managing postoperative refractory bleeding in patients undergoing thoracic aortic surgery. However, the impact of rFVIIa on thromboembolic complications and mortality rates remains unclear.
摘要：
背景：胸主动脉手术后出血是一种常见的并发症，并且可能与发病率和死亡率的显着增加有关。重组激活因子VII（rFVIIa）最初被开发用于治疗血友病患者；然而，在胸主动脉手术后，它越来越多地用于实现止血。
目的：本范围综述旨在提供有关rFVIIa在胸主动脉手术后难治性术后出血治疗中的作用的现有文献。
结果：使用Medline进行了电子数据库搜索，Embase,科克伦图书馆,和谷歌学者在2023年6月。作者包括报道rFVIIa在接受升或降主动脉瘤或夹层手术修复的患者中使用的研究。单病例报告被排除。确定了10篇出版物，汇集了649名患者（319名患者接受rFVIIa，对照组为330名）：3个病例系列，6个回顾性研究，和1个非随机临床试验。所有研究都报道了rFVIIa在纠正凝血障碍和减少该组患者术后失血中的潜在作用。总的来说,没有足够的证据表明rFVIIa与较高的血栓栓塞并发症或死亡率相关.
结论：有限的证据表明，rFVIIa可用于治疗胸主动脉手术患者术后顽固性出血。然而,rFVIIa对血栓栓塞并发症和死亡率的影响尚不清楚.
目的：本范围综述旨在提供有关rFVIIa在胸主动脉手术后难治性术后出血治疗中的作用的现有文献。
结果：使用Medline进行了电子数据库搜索，Embase,科克伦图书馆,和谷歌学者在2023年6月。作者包括报道rFVIIa在接受升或降主动脉瘤或夹层手术修复的患者中使用的研究。单病例报告被排除。确定了10篇出版物，汇集了649名患者（319名患者接受rFVIIa，对照组为330名）：3个病例系列，6个回顾性研究，和1个非随机临床试验。所有研究都报道了rFVIIa在纠正凝血障碍和减少该组患者术后失血中的潜在作用。总的来说,没有足够的证据表明rFVIIa与较高的血栓栓塞并发症或死亡率相关.
结论：有限的证据表明，rFVIIa可用于治疗胸主动脉手术患者术后顽固性出血。然而,rFVIIa对血栓栓塞并发症和死亡率的影响尚不清楚.
