ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Goldstein, D. J.
Right arrow Articles by Oz, M. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Goldstein, D. J.
Right arrow Articles by Oz, M. C.

Ann Thorac Surg 1995;59:1063-1067
© 1995 The Society of Thoracic Surgeons

Use of Aprotinin in LVAD Recipients Reduces Blood Loss, Blood Use, and Perioperative Mortality

Daniel J. Goldstein, MD, J. Alex Seldomridge, BS, Jonathan M. Chen, MD, Katharine A. Catanese, RN, Carolyn M. DeRosa, BS, Alan D. Weinberg, MS, Craig R. Smith, MD, Eric A. Rose, MD, Howard R. Levin, MD, Mehmet C. Oz, MD

Divisions of Cardiothoracic Surgery and Circulatory Physiology, College of Physicians & Surgeons, Columbia University, New York, New York

Aprotinin, a bovine protease inhibitor, has been used extensively in patients undergoing cardiac surgical procedures in an effort to minimize blood loss and prevent the complications associated with blood replacement. We sought to evaluate the effect of aprotinin on postoperative blood loss, renal function, and the incidence of right ventricular failure in patients undergoing placement of a TCI Heartmate left ventricular assist device as a bridge to cardiac transplantation. Retrospective data analysis in 142 patients (42 receiving aprotinin and 100 untreated) demonstrated that the use of aprotinin was associated with a significant decrease in postoperative blood loss (p = 0.019) and in the intraoperative packed red blood cell transfusion (p = 0.019) and total blood product (p = 0.016) requirements. A transient, yet significant, increase in the postoperative creatinine level in the aprotinin group (p = 0.0006), but not in blood urea nitrogen level (p = 0.22), was noted. Interestingly, we noted an association between blood loss and the subsequent development of right ventricular failure; patients who required a right ventricular assist device bled significantly more than did those who did not suffer right ventricular failure (p = 0.02). Additionally, aprotinin recipients benefited by a reduction of nearly one half in the incidence of the need for a right ventricular assist device. The incidence of perioperative mortality was reduced in those receiving aprotinin compared with that in untreated patients, (p = 0.05). We conclude that aprotinin is safe and effective in decreasing postoperative blood loss and intraoperative blood product requirements, and in reducing perioperative mortality in patients undergoing left ventricular assist device placement as a bridge to cardiac transplantation.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
I. Apostolidou, M. F. Sweeney, E. Missov, L. D. Joyce, R. John, and R. C. Prielipp
Acute Left Atrial Thrombus After Recombinant Factor VIIa Administration During Left Ventricular Assist Device Implantation in a Patient with Heparin-Induced Thrombocytopenia
Anesth. Analg., February 1, 2008; 106(2): 404 - 408.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
I. George and M. C. Oz
Myocardial Revascularization after Acute Myocardial Infarction
Card. Surg. Adult, January 1, 2008; 3(2008): 669 - 696.
[Full Text]

Home page
 Card Surg AdultHome page
S. Aggarwal, F. Cheema, M. C. Oz, and Y. Naka
Long-Term Mechanical Circulatory Support
Card. Surg. Adult, January 1, 2008; 3(2008): 1609 - 1628.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
J. N. Schroder, M. A. Daneshmand, N. R. Villamizar, R. P. Petersen, L. J. Blue, I. J. Welsby, A. J. Lodge, T. L. Ortel, J. G. Rogers, and C. A. Milano
Heparin-Induced Thrombocytopenia in Left Ventricular Assist Device Bridge-to-Transplant Patients
Ann. Thorac. Surg., September 1, 2007; 84(3): 841 - 846.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. G. Drakos, J. C. Stringham, J. W. Long, E. M. Gilbert, T. C. Fuller, B. K. Campbell, B. D. Horne, M. E. Hagan, K. E. Nelson, J. M. Lindblom, et al.
Prevalence and risks of allosensitization in HeartMate left ventricular assist device recipients: The impact of leukofiltered cellular blood product transfusions
J. Thorac. Cardiovasc. Surg., June 1, 2007; 133(6): 1612 - 1619.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
L. Santambrogio, T. Bianchi, M. Fuardo, F. Gazzoli, R. Veronesi, A. Braschi, and M. Maurelli
Right ventricular failure after left ventricular assist device insertion: preoperative risk factors
Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 379 - 382.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. R. Cooper Jr, J. Abrams, O.H. Frazier, R. Radovancevic, B. Radovancevic, A. W. Bracey, M. J. Kindo, and I. D. Gregoric
Fatal pulmonary microthrombi during surgical therapy for end-stage heart failure: Possible association with antifibrinolytic therapy
J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 963 - 968.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. A. Morgan, R. John, V. Rao, A. D. Weinberg, B. J. Lee, P. A. Mazzeo, M. R. Flannery, J. M. Chen, M. C. Oz, and Y. Naka
Bridging to transplant with the HeartMate left ventricular assist device: The Columbia Presbyterian 12-year experience
J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1309 - 1316.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. J. Goldstein and R. B. Beauford
Left ventricular assist devices and bleeding: adding insult to injury
Ann. Thorac. Surg., June 1, 2003; 75(90060): S42 - 47.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
W. E. Richenbacher, Y. Naka, E. P. Raines, O. H. Frazier, G. S. Couper, F. D. Pagani, L. Damme, C. H. VanMeter, G. J. Magovern Jr, L. Gupta, et al.
Surgical management of patients in the REMATCH trial
Ann. Thorac. Surg., June 1, 2003; 75(90060): S86 - 92.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
V. Rao, M. C. Oz, M. A. Flannery, K. A. Catanese, M. Argenziano, and Y. Naka
Revised screening scale to predict survival after insertion of a left ventricular assist device
J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 855 - 862.
[Abstract] [Full Text]

Home page
 Card Surg AdultHome page
D. C. Lee, W. Ting, and M. C. Oz
Myocardial Revascularization after Acute Myocardial Infarction
Card. Surg. Adult, January 1, 2003; 2(2003): 639 - 658.
[Full Text]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
P. Naughton and C. A. Bashour
Mechanical Support After Cardiac Surgery
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2002; 6(3): 237 - 257.
[Abstract] [PDF]

Home page
 J Am Coll CardiolHome page
M. P. Siegenthaler, J.u. Martin, A. van de Loo, T. Doenst, W. Bothe, and F. Beyersdorf
Implantation of the permanent jarvik-2000 left ventricular assist device: A single-center experience
J. Am. Coll. Cardiol., June 5, 2002; 39(11): 1764 - 1772.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M.P. Siegenthaler, J. Martin, O.H. Frazier, and F. Beyersdorf
Implantation of the permanent Jarvik-2000 left-ventricular-assist-device: surgical technique
Eur. J. Cardiothorac. Surg., March 1, 2002; 21(3): 546 - 548.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. A. Bedirhan, A. Turna, N. Yagan, and O. Tasci
Aprotinin reduces postoperative bleeding and the need for blood products in thoracic surgery: results of a randomized double-blind study
Eur. J. Cardiothorac. Surg., December 1, 2001; 20(6): 1122 - 1127.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
O. H. Frazier, E. A. Rose, M. C. Oz, W. Dembitsky, P. McCarthy, B. Radovancevic, V. L. Poirier, and K. A. Dasse
Multicenter clinical evaluation of the HeartMate vented electric left ventricular assist system in patients awaiting heart transplantation
J. Thorac. Cardiovasc. Surg., December 1, 2001; 122(6): 1186 - 1195.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
J. R Pepper
Surgery for heart failure: options and outcomes
Perfusion, July 1, 2000; 15(4): 287 - 293.
[PDF]

Home page
 PerfusionHome page
D. Gagnon, M. Petty, and J. R Lahpor
HeartMate(R) family of left ventricular assist systems
Perfusion, July 1, 2000; 15(4): 345 - 354.
[PDF]

Home page
 Ann. Thorac. Surg.Home page
K. Fukamachi, P. M. McCarthy, N. G. Smedira, R. L. Vargo, R. C. Starling, and J. B. Young
Preoperative risk factors for right ventricular failure after implantable left ventricular assist device insertion
Ann. Thorac. Surg., December 1, 1999; 68(6): 2181 - 2184.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. N. Helman, D. L.S. Morales, N. M. Edwards, D. M. Mancini, J. M. Chen, E. A. Rose, and M. C. Oz
Left ventricular assist device bridge-to-transplant network improves survival after failed cardiotomy
Ann. Thorac. Surg., October 1, 1999; 68(4): 1187 - 1194.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Mavroidis, B. C. Sun, and W. E. Pae Jr
Bridge to transplantation: the Penn State experience
Ann. Thorac. Surg., August 1, 1999; 68(2): 684 - 687.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. C. Sun, K. A. Catanese, T. B. Spanier, M. R. Flannery, M. T. Gardocki, L. S. Marcus, H. R. Levin, E. A. Rose, and M. C. Oz
100 long-term implantable left ventricular assist devices: the Columbia Presbyterian interim experience
Ann. Thorac. Surg., August 1, 1999; 68(2): 688 - 694.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
D. J. Goldstein, M. C. Oz, and E. A. Rose
Implantable Left Ventricular Assist Devices
N. Engl. J. Med., November 19, 1998; 339(21): 1522 - 1533.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Baufreton, M. Kirsch, and D. Y. Loisance
Measures to control blood activation during assisted circulation
Ann. Thorac. Surg., November 1, 1998; 66(5): 1837 - 1844.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. Koul, J.-O. Solem, S. Steen, H. Casimir-Ahn, H. Granfeldt, and U. J. Lonn
HeartMate Left Ventricular Assist Device as Bridge to Heart Transplantation
Ann. Thorac. Surg., June 1, 1998; 65(6): 1625 - 1630.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. J. DeRose Jr, J. P. Umana, M. Argenziano, K. A. Catanese, H. R. Levin, B. C. Sun, E. A. Rose, and M. C. Oz
Improved Results for Postcardiotomy Cardiogenic Shock With the Use of Implantable Left Ventricular Assist Devices
Ann. Thorac. Surg., December 1, 1997; 64(6): 1757 - 1762.
[Abstract] [Full Text]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
D. Royston
Hemostatic Drugs in Prothrombotic or Hypercoagulable States
Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 1997; 1(4): 376 - 394.
[Abstract] [PDF]

Home page
 CirculationHome page
MehmetC. Oz, M. Argenziano, K. A. Catanese, M. T. Gardocki, D. J. Goldstein, R. C. Ashton, A. C. Gelijns, E. A. Rose, and H. R. Levin
Bridge Experience With Long-term Implantable Left Ventricular Assist Devices: Are They an Alternative to Transplantation?
Circulation, April 1, 1997; 95(7): 1844 - 1852.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
A. M. Scheule, M. J. Jurmann, H. P. Wendel, L. Haberle, F. S. Eckstein, and G. Ziemer
Anaphylactic Shock After Aprotinin Reexposure: Time Course of Aprotinin-Specific Antibodies
Ann. Thorac. Surg., January 1, 1997; 63(1): 242 - 244.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
W. E. Richenbacher and W. S. Pierce
Mechanical Circulatory Support
Ann. Thorac. Surg., November 1, 1996; 62(5): 1558 - 1559.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
T. W. Prendergast, S. Furukawa, A. J. Beyer III, H. J. Eisen, J. B. McClurken, and V. Jeevanandam
Defining the Role of Aprotinin in Heart Transplantation
Ann. Thorac. Surg., September 1, 1996; 62(3): 670 - 674.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
L. Martinelli, M. Maurelli, M. Vigano', and M. C. Oz
Aprotinin in Staged Heart Transplantation: Anaphylactic Potential of Repeated Exposure
Ann. Thorac. Surg., April 1, 1996; 61 (4): 1288 - 1289.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
D. J. Goldstein, M. C. Oz, C. R. Smith, J. P. Friedlander, C. M. De Rosa, L. B. Mongero, and E. Delphin
Safety of Repeat Aprotinin Administration for LVAD Recipients Undergoing Cardiac Transplantation
Ann. Thorac. Surg., February 1, 1996; 61(2): 692 - 695.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1995 by The Society of Thoracic Surgeons.