Recombinant activated factor VII in cardiac surgery – first, do no harm

Letter to the editor We read with interest Heise et al's case report and review of the literature regarding the use of recombinant activated factor VII (rFVIIa) in patients with ventricular assist devices (VAD) [1]. Whilst we welcome the addition to the literature in this area, there are two key areas regarding this relatively novel haemostatic agent that we felt the authors had failed to address appropriately, and that may therefore mislead the practicing cardiac surgeon.