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Ann Thorac Surg 1995;59:438-442
© 1995 The Society of Thoracic Surgeons

Hemostatic Efficacy of Dipyridamole, Tranexamic Acid, and Aprotinin in Coronary Bypass Grafting

Ron G. H. Speekenbrink, MD, Alexander B. A. Vonk, MD, Charles R. H. Wildevuur, MD, PhD, Leon Eijsman, MD, PhD

Department of Thoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands

Accepted for publication October 7, 1994.

Sixty patients (four groups of 15 patients) were entered in a randomized, controlled study to compare the efficacy of prophylactic treatment with dipyridamole, tranexamic acid, and aprotinin to reduce bleeding after elective coronary artery bypass grafting. Only patients with a preoperative platelet count of less than 246 x 109/L were selected because a previous study showed that these individuals are at risk for increased postoperative bleeding. Compared to control subjects, postoperative blood loss 6 hours after operation was significantly reduced by tranexamic acid (674 ± 411 versus 352 ± 150 mL; p < 0.05) and by aprotinin (270 ± 174 mL; p < 0.01). Dipyridamole did not reduce postoperative blood loss and was associated with complications in 3 patients. We conclude that hemostasis after cardiac operations can be improved with tranexamic acid and aprotinin. Dipyridamole appeared to be ineffective.




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