Tranexamic Acid and Aprotinin in Primary Cardiac Operations: An Analysis of 220 Cardiac Surgical Patients Treated with Tranexamic Acid or Aprotinin

Abstract

Considering the rate of transfusion of red blood cells, tranexamic acid was slightly inferior in patients undergoing CABG, but there was no difference in patients receiving AVR. Tranexamic acid seems to be less effective in operations with increased bleeding such as CABG. Clinical benefit depends on specific patient and institution characteristics (ClinicalTrials.gov NCT00396760).

Re-evaluation of the role of antifibrinolytic therapy with lysine analogs during cardiac surgery in the post aprotinin era

“…Dietrich et al [16] compared tranexamic acid given in a high dose of approximately 6 g (bolus of 20 mg/kg for the patient, 2 g in the CPB priming solution, continuous infusion of 1 g/h) to high-dose aprotinin. Two hundred and twenty patients scheduled for primary CABG surgery or aortic valve replacement (AVR) were enrolled in this prospective, randomized, double-blinded study.…”

Enhanced Thrombin Generation After Cardiopulmonary Bypass Surgery

“…Quantitative data about blood loss and transfusion requirements are published elsewhere. 35 In all patients, standard anesthesia was performed using sufentanil and midazolam supplemented with sevoflurane inhalation; neuromuscular blockade was achieved and maintained by either pancuronium bromide or rocuronium. During CPB, nonpulsatile pump flow was used with moderate systemic hypothermia of 32°C.…”

The risks associated with aprotinin use: a retrospective study of cardiac cases in Nova Scotia

“…[3][4][5][6][7][8][9] Numerous studies outlined purported risks of aprotinin use compared with both placebo and the lysine analogues. 9,10 The focus of this retrospective analysis is on elucidation of the safety and efficacy of aprotinin compared with TXA in cardiac surgery.…”