ObjectiveThe authors present the use of synthetic factor VIIa to treat bleeding after cardiopulmonary bypass and surgical repair of an atrial septal defect in an infant with trisomy 10 and pulmonary hypertension.DesignCase report.SettingUniversity-affiliated pediatric intensive care unit.PatientsA 4-mo-old, 3.7-kg infant.Main ResultsAfter a single dose of synthetic factor VIIa, there was normalization of the prothrombin and partial thromboplastin time and cessation of bleeding.ConclusionThe potential benefits of synthetic factor VIIa when compared with conventional therapy with fresh frozen plasma are discussed. Previous experience with synthetic factor VIIa in pediatric-aged patients and the cardiothoracic surgical population is presented.