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Ann Thorac Surg 1996;62:1667-1668
© 1996 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1659.

DR BENJAMIN P. BIDSTRUP (Townsville, Australia): I thank Dr Lemmer and associates for the opportunity to review the manuscript today. I have a number of questions and comments related to this. This study will certainly help allay some of the fears that people have had about the possible association of aprotinin with perioperative MI. You certainly have quite a powerful study, and in combination with other previous studies that have looked at this, I think we can try and lay these concerns to rest.

I do, however, have some other concerns. In the manuscript you have pointed out that the use of the synthetic antifibrinolytic agents was allowed in the pump-prime--only group. Six percent of those patients received {epsilon}-aminocaproic acid. Given that there is a significant difference in the mode of action of the synthetic antifibrinolytics and the mode of action of aprotinin, you might care to comment on this combination. I certainly would not recommend the combined use of both of these drugs because of the lack of safety data, in particular of the synthetic antifibrinolytics. It is possible that {epsilon}-aminocaproic acid is associated with an increase in the incidence of MI.

DR LEMMER: Thank you, Dr Bidstrup. The patients enrolled in the study were . . . [Full Text of this Article]


Related Article

Aprotinin for Primary Coronary Artery Bypass Grafting: A Multicenter Trial of Three Dose Regimens
John H. Lemmer, Jr, Emery W. Dilling, Jeremy R. Morton, Jeffrey B. Rich, Francis Robicsek, Donald L. Bricker, Charles B. Hantler, Jack G. Copeland, III, John L. Ochsner, Pat O. Daily, Charles W. Whitten, George P. Noon, and Rosemarie Maddi
Ann. Thorac. Surg. 1996 62: 1659-1668. [Abstract] [Full Text]



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