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Ann Thorac Surg 1994;58:1036-1039
© 1994 The Society of Thoracic Surgeons

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Articles

Aprotinin preserves hemostasis in aspirin-treated patients undergoing cardiopulmonary bypass

^a Thorax Center, University Hospital Groningen, Groningen, The Netherlands
^b Department of Clinical Chemistry, University of Leiden, Leiden, The Netherlands
^c Department of Cardiopulmonary Surgery, Academic Medical Center, Amsterdam, The Netherlands

Accepted for publication January 21, 1994.

^_* Address reprint requests to Dr Tabuchi, Research Division, Department of Cardiopulmonary Surgery, University Hospital, Oostersingel 59, 9713 EZ Groningen, The Netherlands.

Various clinical trials have shown that hemostasis is improved by the administration of aprotinin during Cardiopulmonary bypass. However, this effect has not been proved for those patients treated preoperatively with aspirin. Therefore, a double-blind, placebo-controlled study was conducted to test the efficacy of low-dose aprotinin (2 x 10⁶ KIU in the pump prime solution) in preserving hemostasis in 40 aspirin-treated (325 mg) patients undergoing coronary artery bypass grafting. Aprotinin brought about a decrease in the postoperative blood loss (p < 0.05). The in vitro bleeding test (Thrombostat) demonstrated that aprotinin preserved the platelet hemostatic function in aspirin-treated patients during cardiopulmonary bypass (p < 0.05). The inhibitory effects of aspirin on collagen-induced platelet aggregation and thromboxane production were not influenced by aprotinin treatment. The findings from the present study indicate that aprotinin preserves hemostasis in aspirin-treated patients during Cardiopulmonary bypass, but aspirin's effect on platelets is maintained. Therefore, aprotinin seems to be a useful adjunct treatment in aspirin-treated patients undergoing coronary artery bypass grafting.

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