JTCS Tips for Better Browsing
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 Author home page(s):
John M. Murkin
Gerard M. Guiraudon
Alan H. Menkis
F. Neil McKenzie
Richard J. Novick
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 Murkin, J. M.
Right arrow Articles by Novick, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Murkin, J. M.
Right arrow Articles by Novick, R. J.

J Thorac Cardiovasc Surg 1994;107:554-0561
© 1994 Mosby, Inc.

Cardiopulmonary Bypass, Myocardial Management, and Support Techniques

Aprotinin significantly decreases bleeding and transfusion requirements in patients receiving aspirin and undergoing cardiac operations

John M. Murkin, MD, FRCPCa, JoAnn Lux, PhDb, Nicola A. Shannon, RNa, Gerard M. Guiraudon, MD, FRCSCc, Alan H. Menkis, MD, FRCSCc, F. Neil McKenzie, MB, FRSCSc, Richard J. Novick, MD, FRCSC, FACSc


London and Etobicoke, Ontario, Canada

Supported in part by Miles Canada Inc.

Received for publication Feb. 2, 1993. Accepted for publication June 9, 1993. Address for reprints: John M. Murkin, MD, FRCPC, Department of Anaesthesia, University Hospital, 339 Windermere Rd., London, Ontario, Canada N6A 5A5.

Abstract

Background: Patients with heart disease are frequently maintained on a regimen of aspirin because of its ability to decrease thrombotic complications and reduce the prevalence of unstable angina and myocardial infarction. Aspirin-induced platelet acetylation also increases bleeding caused by impairment of platelet function during cardiac surgery. Methods: Between October 1990 and November 1991 this double-blind, randomized, placebo-controlled, parallel group interventional study examined the efficacy of high-dose aprotinin administration (up to 7 million KIU) to decrease blood loss and transfusion requirements in patients receiving aspirin within 48 hours of undergoing coronary bypass or valvular heart operations. Primary outcome measures in this study were total volume of blood loss (intraoperative blood loss plus postoperative chest tube drainage) and volume of transfusion during hospitalization. Results: Patients treated with aprotinin (n = 29) had significantly lower total blood loss (1409 ± 232 ml versus 2765 ± 248 ml; p = 0.0002), intraoperative blood loss (503 ± 53 ml versus 1055 ± 199 ml; p = 0.0001), postoperative blood loss (906 ± 204 ml versus 1710 ± 202 ml; p = 0.0074), and prevalence of transfusion (59% versus 88% of patients; p = 0.016) than the placebo group (n = 25). The prevalence of complications including myocardial infarction was similar in the two groups. Conclusions: High-dose aprotinin significantly reduces blood loss and red blood cell transfusions in patients receiving aspirin who undergo cardiac operations. (J THORAC CARDIOVASC SURG 1994;107:554-61)




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
S. Maltais, L. P. Perrault, and Q.-B. Do
Effect of clopidogrel on bleeding and transfusions after off-pump coronary artery bypass graft surgery: impact of discontinuation prior to surgery.
Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 127 - 131.
[Abstract] [Full Text] [PDF]

Home page
 CLIN APPL THROMB HEMOSTHome page
A. P. Bode, R. M. Lust, M. S. Read, and T. H. Fischer
Correction of the Bleeding Time With Lyophilized Platelet Infusions in Dogs on Cardiopulmonary Bypass
Clinical and Applied Thrombosis/Hemostasis, January 1, 2008; 14(1): 38 - 54.
[Abstract] [PDF]

Home page
 Card Surg AdultHome page
L. Y. Lee, W. J. DeBois, K. H. Krieger, and O. W. Isom
Transfusion Therapy and Blood Conservation
Card. Surg. Adult, January 1, 2008; 3(2008): 415 - 430.
[Full Text]

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
 Eur. J. Cardiothorac. Surg.Home page
G. Veres, T. Radovits, H. Schultz, L.-n. Lin, J. Hutter, E. Weigang, Z. Szabolcs, and G. Szabo
Effect of recombinant aprotinin on postoperative blood loss and coronary vascular function in a canine model of cardiopulmonary bypass
Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 340 - 345.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
R. V Purugganan, D. Thakar, B. Riedel, D Rice, W. Smythe, and P. Norman
44255 - APROTININ SIGNIFICANTLY DECREASES TRANSFUSION RATES IN EXTRAPLEURAL PNEUMONECTOMY
Can J Anesth, August 1, 2007; 54(suppl_1): 44255 - 44255.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
J. R. Brown, N. J.O. Birkmeyer, and G. T. O'Connor
Meta-Analysis Comparing the Effectiveness and Adverse Outcomes of Antifibrinolytic Agents in Cardiac Surgery
Circulation, June 5, 2007; 115(22): 2801 - 2813.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
C. K. Choong, C. Gerrard, K. A. Goldsmith, H. Dunningham, and A. Vuylsteke
Delayed re-exploration for bleeding after coronary artery bypass surgery results in adverse outcomes
Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 834 - 838.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
A. Ouattara, H. Bouzguenda, Y. Le Manach, P. Leger, A. Mercadier, P. Leprince, N. Bonnet, G. Montalescot, B. Riou, and P. Coriat
Impact of aspirin with or without clopidogrel on postoperative bleeding and blood transfusion in coronary surgical patients treated prophylactically with a low-dose of aprotinin
Eur. Heart J., April 12, 2007; (2007) ehm049v1.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
A. Ronald and J. Dunning
Does use of aprotinin decrease the incidence of stroke and neurological complications in adult patients undergoing cardiac surgery?
Interactive CardioVascular and Thoracic Surgery, December 1, 2006; 5(6): 767 - 773.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Lindvall, U. Sartipy, and J. van der Linden
Aprotinin Reduces Bleeding and Blood Product Use in Patients Treated With Clopidogrel Before Coronary Artery Bypass Grafting
Ann. Thorac. Surg., September 1, 2005; 80(3): 922 - 927.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
J. van der Linden, G. Lindvall, and U. Sartipy
Aprotinin Decreases Postoperative Bleeding and Number of Transfusions in Patients on Clopidogrel Undergoing Coronary Artery Bypass Graft Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial
Circulation, August 30, 2005; 112(9_suppl): I-276 - I-280.
[Abstract] [Full Text] [PDF]

Home page
 Clin TrialsHome page
D. Fergusson, K. C. Glass, B. Hutton, and S. Shapiro
Randomized controlled trials of aprotinin in cardiac surgery: could clinical equipoise have stopped the bleeding?
Clinical Trials, June 1, 2005; 2(3): 218 - 232.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. W.A. Chu, S. R. Wilson, R. J. Novick, L. W. Stitt, and M. A. Quantz
Does Clopidogrel Increase Blood Loss Following Coronary Artery Bypass Surgery?
Ann. Thorac. Surg., November 1, 2004; 78(5): 1536 - 1541.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Sedrakyan, T. Treasure, and J. A. Elefteriades
Effect of aprotinin on clinical outcomes in coronary artery bypass graft surgery: A systematic review and meta-analysis of randomized clinical trials
J. Thorac. Cardiovasc. Surg., September 1, 2004; 128(3): 442 - 448.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
L. Y. Lee, W. J. DeBois, K. H. Krieger, and O. W. Isom
Transfusion Therapy and Blood Conservation
Card. Surg. Adult, January 1, 2003; 2(2003): 389 - 400.
[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
 J Am Coll CardiolHome page
R. H. Hongo, J. Ley, S. E. Dick, and R. R. Yee
The effect of clopidogrel incombination with aspirin whengiven before coronary artery bypass grafting
J. Am. Coll. Cardiol., July 17, 2002; 40(2): 231 - 237.
[Abstract] [Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
J. M. Murkin
Adverse Central Nervous System Outcomes After Cardiopulmonary Bypass: A Beneficial Effect of Aprotinin?
Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 282 - 285.
[Abstract] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. M. Alvarez, L. R. Jackson, C. Chatwin, and J. J. Smolich
Low-dose postoperative aprotinin reduces mediastinal drainage and blood product use in patients undergoing primary coronary artery bypass grafting who are taking aspirin: A prospective, randomized, double-blind, placebo-controlled trial
J. Thorac. Cardiovasc. Surg., September 1, 2001; 122(3): 457 - 463.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. J. Dignan, D. W. Law, P. W. Seah, C. W. Manganas, D. C. Newman, P. W. Grant, and H. D. Wolfenden
Ultra-low dose aprotinin decreases transfusion requirements and is cost effective in coronary operations
Ann. Thorac. Surg., January 1, 2001; 71(1): 158 - 164.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J.-O. Defraigne, J. Pincemail, G. Dekoster, R. Larbuisson, M. Dujardin, F. Blaffart, J.-L. David, and R. Limet
SMA circuits reduce platelet consumption and platelet factor release during cardiac surgery
Ann. Thorac. Surg., December 1, 2000; 70(6): 2075 - 2081.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
V. Casati, D. Guzzon, M. Oppizzi, F. Bellotti, A. Franco, C. Gerli, M. Cossolini, G. Torri, G. Calori, S. Benussi, et al.
Tranexamic acid compared with high-dose aprotinin in primary elective heart operations: Effects on perioperative bleeding and allogeneic transfusions
J. Thorac. Cardiovasc. Surg., September 1, 2000; 120(3): 520 - 527.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
S. V Moran, G. Lema, J. Medel, M. J Irarrazaval, R. Zalaquett, B. Garayar, and R. Flaskamp
Comparison of two doses of aprotinin in patients receiving aspirin before coronary bypass surgery
Perfusion, March 1, 2000; 15(2): 105 - 110.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. P. Bidstrup, B. J. Hunt, S. Sheikh, R. N. Parratt, J. M. Bidstrup, and R. N. Sapsford
Amelioration of the bleeding tendency of preoperative aspirin after aortocoronary bypass grafting
Ann. Thorac. Surg., February 1, 2000; 69(2): 541 - 547.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. Klein, P.R. Keith, H.-P. Dauben, H.D. Schulte, H. Beckmann, G. Mayer, O. Elert, and E. Gams
Aprotinin counterbalances an increased risk of peri-operative haemorrhage in CABG patients pre-treated with Aspirin
Eur. J. Cardiothorac. Surg., October 1, 1999; 14(4): 360 - 366.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
J. J. Munoz, N. J. O. Birkmeyer, J. D. Birkmeyer, G. T. O'Connor, and L. J. Dacey
Is {epsilon}-Aminocaproic Acid as Effective as Aprotinin in Reducing Bleeding With Cardiac Surgery? : A Meta-Analysis
Circulation, January 12, 1999; 99(1): 81 - 89.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
J. A. Hyde, J. A Chinn, and T. R Graham
Platelets and cardiopulmonary bypass
Perfusion, December 1, 1998; 13(6): 389 - 407.
[PDF]

Home page
 Ann. Thorac. Surg.Home page
B. E. Miller, S. R. Tosone, V. K.H. Tam, K. R. Kanter, N. A. Guzzetta, J. M. Bailey, and J. H. Levy
Hematologic and economic impact of aprotinin in reoperative pediatric cardiac operations
Ann. Thorac. Surg., August 1, 1998; 66(2): 535 - 540.
[Abstract] [Full Text] [PDF]

Home page
 CLIN APPL THROMB HEMOSTHome page
R. Pifarre
Use of Aprotinin in the Control of Bleeding During Cardiopulmonary Bypass Surgery: Current Status
Clinical and Applied Thrombosis/Hemostasis, January 1, 1998; 4(1): 2 - 6.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. H. Lemmer Jr, E. W. Dilling, J. R. Morton, J. B. Rich, F. Robicsek, D. L. Bricker, C. B. Hantler, J. G. Copeland III, J. L. Ochsner, P. O. Daily, et al.
Aprotinin for Primary Coronary Artery Bypass Grafting: A Multicenter Trial of Three Dose Regimens
Ann. Thorac. Surg., December 1, 1996; 62(6): 1659 - 1668.
[Abstract] [Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Cicek, U. Demirkilic, E. Ozal, E. Kuralay, H. Bingol, H. Tatar, and O. Y. Ozturk
POSTOPERATIVE USE OF APROTININ IN CARDIAC OPERATIONS: AN ALTERNATIVE TO ITS PROPHYLACTIC USE
J. Thorac. Cardiovasc. Surg., December 1, 1996; 112(6): 1462 - 1467.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
R. E. Helm, J. D. Klemperer, T. K. Rosengart, J. P. Gold, P. Peterson, W. DeBois, N. K. Altorki, S. Lang, S. Thomas, O. W. Isom, et al.
Intraoperative Autologous Blood Donation Preserves Red Cell Mass But Does Not Decrease Postoperative Bleeding
Ann. Thorac. Surg., November 1, 1996; 62(5): 1431 - 1441.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
P. G. M. Jansen, C. Baufreton, P. Le Besnerais, D. Y. Loisance, and C. R. H. Wildevuur
Heparin-Coated Circuits and Aprotinin Prime for Coronary Artery Bypass Grafting
Ann. Thorac. Surg., May 1, 1996; 61(5): 1363 - 1366.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
S. Cicek, U. Demirkilic, E. Kuralay, E. Ozal, and H. Tatar
Postoperative Aprotinin: Effect on Blood Loss and Transfusion Requirements in Cardiac Operations
Ann. Thorac. Surg., May 1, 1996; 61(5): 1372 - 1376.
[Abstract] [Full Text]

Home page
 PerfusionHome page
I. Rodrigus, K. Vermeyen, S. De Hert, B. Amsel, and P. Walter
Efficacy and safety of aprotinin in aortocoronary bypass and valve replacement operations: a placebo-controlled randomized double-blind study
Perfusion, January 1, 1996; 11(4): 313 - 318.
[Abstract] [PDF]

Home page
 CirculationHome page
J. H. Levy, R. Pifarre, H. V. Schaff, J. C. Horrow, R. Albus, B. Spiess, T. K. Rosengart, J. Murray, R. E. Clark, P. Smith, et al.
A Multicenter, Double-Blind, Placebo-Controlled Trial of Aprotinin for Reducing Blood Loss and the Requirement for Donor-Blood Transfusion in Patients Undergoing Repeat Coronary Artery Bypass Grafting
Circulation, October 15, 1995; 92(8): 2236 - 2244.
[Abstract] [Full Text]

Home page
 CLIN APPL THROMB HEMOSTHome page
R. Pifarre
State-of-the-Art Review: Optimal Anticoagulation in Cardiovascular Surgery
Clinical and Applied Thrombosis/Hemostasis, June 1, 1995; 1(3): 173 - 178.
[Abstract] [PDF]


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 © 1994 by The American Association for Thoracic Surgery.