Aprotinin use in thoracic aortic surgery: Safety and outcomes

Abstract

The current evaluation substantiates previous reports that aprotinin may be safe to use and likely to improve some outcomes of thoracic aortic surgery. However, further studies for rare safety and efficacy end points are warranted.

Post‐operative volume therapy in cardiac surgery: effects on hemostatic and circulatory variables

“…Several studies have reported that both CPB and use of colloids per se may activate fibrinolysis (Nielsen 2006), and use of antifibrinolytic drugs has been considered (Sedrakyan et al 2006). The results of the present thesis do not support routine use of fibrinolysis inhibitors in patients undergoing elective cardiac surgery.…”

Trends in Aortic Dissection Hospitalizations, Interventions, and Outcomes Among Medicare Beneficiaries in the United States, 2000–2011

“…Advancements such as use of sophisticated neuroprotection techniques, development of improved intraoperative and postoperative pharmacological therapy, use of operative algorithm and standardized cannulation techniques, as well development of care teams could all have possibly contributed towards improving mortality rates. 1, 3, 7, 9, 10, 25–28 Additionally, part of the improvement in mortality seen with type B dissection could be possible due to the increasing use of endovascular approach in the treatment of surgically high risk patients.…”

“…Especially since several innovations in diagnostic techniques and management of AD have been adopted in the past decade that have promising improved clinical outcomes for those who survive long enough to receive medical care. 7–10 Thus data on the recent epidemiology and outcomes associated with AD could potentially assist in quantifying the present burden of AD, effectiveness of newer interventions as well as provide valuable data for benchmarking performance of future technologies.…”

Pulmonary complications of cardiopulmonary bypass

“…While it is currently not available in the United States, aprotinin, a serine protease inhibitor used for hemostasis and prevention of fibrinolysis in cardiac surgery, has been shown to have a variety of positive effects on multiple organ systems, including the lungs. Aprotinin use has been associated with reduction in ventilation time and pulmonary complications as well as decreased extravascular lung water and improvement in oxygenation indices [118,119]. ConclusionPostoperative pulmonary complications after cardiac surgery with extracorporeal circulation are common and range from transient hypoxemia to the more severe acute lung injury and acute respiratory distress syndrome, which are difficult to are multiple etiologies and patient risk factors but the inflammatory response associated with extracorporeal circulation and cardiopulmonary bypass is thought to play a major role in lung injury and pulmonary complications after cardiac surgery.…”