[Use of recombinant, activated Factor VII in the treatment and prevention of bleeding complications in two female patients suffering from congenital XI factor deficiency during orthopedic and traumatology intervention. Case reports]

The authors describe the treatment of the bleeding complications in two female patients suffering from a rare, inherited coagulation disorder; Factor XI deficiency after having major orthopaedic and traumatologic operations by activated, recombinant Factor VII (NovoSeven, Novo Nordisk, Bagsvaerd, Denmark). In the first case a total hip arthroplasty was performed because of severe, left-sided osteoarthritis. Despite of the standard protocol prescribed by the National Haemophilia Centre, severe bleeding complication occurred. The authors describe the pattern of the postoperative bleeding, the difficult decision on reoperation and the experience with activated, recombinant Factor VII, as a rescue treatment. In the second case the patient had a right femoral head fracture after falling. In her anamnesis it was known that she had severe bleeding complications despite factor substitution. After discussion with the National Haemophilia Centre operation was made by the use of NovoSeven.