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The Annals of Thoracic Surgery, Vol 55, 659-661, Copyright © 1993 by The Society of Thoracic Surgeons
H Tatar, S Cicek, U Demirkilic, E Ozal, H Suer, O Ozturk and H Isiklar
Among various pharmacological agents used to reduce bleeding after open-
heart operations, high-dose aprotinin therapy seems most promising.
However, its long-term effects are still obscure; there is almost always
possibility of bypass graft occlusions produced by the hypercoagulable
state induced by aprotinin in coronary bypass operations. Topical
application of aprotinin into the pericardial cavity could prevent the
adverse effects. Fifty patients were prospectively studied to evaluate the
effects of topical aprotinin. One million KIU of aprotinin was poured into
the pericardial cavity before closure of the sternotomy in group 1 (n =
25). Patients in group 2 (n = 25) served as controls. Total postoperative
bleeding was significantly reduced in group 1 when compared with that of
group 2 (722.7 +/- 230.8 versus 1,282.6 +/- 225.7 mL; p < 0.01). The use
of banked donor blood products was significantly less in group 1 than in
group 2 (0.33 +/- 0.67 versus 1.36 +/- 0.86 units; p < 0.01). These
results show that topical use of aprotinin reduces post-operative blood
loss and need for transfusion. It seems promising and warrants further
studies to be done.
ARTICLES
Topical use of aprotinin in open heart operations
Department of Cardiovascular Surgery, GATA, Gulhane School of Medicine, Ankara, Turkey.
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