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Ann Thorac Surg 1993;55:971-976
© 1993 The Society of Thoracic Surgeons

Articles

Aprotinin therapy in cardiac operations: A report on use in 41 cardiac centers in the United Kingdom

Ben P. Bidstrup, FRACSa,b,c,d,e, Judy Harrison, MBa,b,c,d,e, David Royston, FFRACSa,b,c,d,e, Kenneth M. Taylor, FRCS*,a,b,c,d,e, Tom Treasure, FRCSa,b,c,d,e

a Cardiothoracic Units, Wellington Hospital, London United Kingdom
b Harefield Hospital, Middlesex United Kingdom
c Hammersmith Hospital, London United Kingdom
d St. George's Hospital, London United Kingdom
e Bayer UK, Newbury, Berks, United Kingdom

Accepted for publication July 31, 1992.

* Address reprint requests to Dr Taylor, Cardiothoracic Surgery Unit, Royal Postgraduate Medical School, Hammersmith Hospital, DuCane Rd, London, W12 0NN, United Kingdom.

Aprotinin, a serine protease inhibitor, has recently been shown to reduce blood loss in cardiac surgical patients. Data on the safety and efficacy of aprotinin therapy administered to 671 cardiac surgical patients in 41 United Kingdom cardiac surgical units have been submitted to interim analysis. The patients studied were in high-risk categories for excessive bleeding, including 457 redo operations and 79 patients with active infective endocarditis. Overall mortality was 12% in redo cases and 5.1% in first-time operations. Adverse events were reported in only 20 patients (3%). Median blood loss at 24 hours after operation was 400 mL, and median transfusion volume throughout the operative and postoperative period was 2 units. These data confirm that the use of aprotinin therapy in high-risk cardiac surgical patients is associated with a low incidence of adverse events.




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