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Ann Thorac Surg 2007;84:986-987
© 2007 The Society of Thoracic Surgeons
Emory Hospital, 1364 Clifton Rd, Atlanta, GA 30322
(Email: jerrold.levy@emoryhealthcare.org; seth.force@emoryhealthcare.org).
Aprotinin consistently reduces bleeding and transfusion requirements in a broad spectrum of surgical patients. Although cardiac surgery is the most extensively studied, with 3,789 patients in randomized placebo-controlled studies, it also reduces transfusions as reported in other surgical patients [1–5]. The common pathway for the effectiveness of aprotinin may be the ability to minimize tissue injury or contact activation, or both, that occurs in surgical patients, including orthopedic and hepatic transplantation [4, 5]. Extrapleural pneumonectomy is a formidable procedure that is associated with a 3% to 5% incidence of complications due to hemorrhage. The denuded pleural surface provides a large surface area for slow continual
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