Very Low-Dose Recombinant Activated Factor VIIa: A Paradigm Shift in Major Bleeding Therapy?

Objectives: Recombinant activated factor VIIa (rFVIIa) has become an important component in major bleeding therapy, although its usage in patients without hemophilia is off-label. However, recent reports on enhanced morbidity and mortality in patients after heart surgery, particularly due to thromboembolic complications, have raised a controversy on indications and contraindications of rFVIIa.