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J Thorac Cardiovasc Surg 1994;107:807-810
© 1994 Mosby, Inc.


CARDIOPULMONARY BYPASS,
MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

Aprotinin does not decrease early graft patency after coronary artery bypass grafting despite reducing postoperative bleeding and use of donated blood

Michael Havel, MD, Florian Grabenwöger, MD, Johannes Schneider, MD, Günter Laufer, MD, Gregor Wollenek, MD, Alyson Owen, MD, Paul Simon, MD, Harald Teufelsbauer, MD, Ernst Wolner, MD


Vienna, Austria

From the Second Department of Surgery, University Hospital of Vienna, Vienna, Austria.

Received for publication Feb. 2, 1993. Accepted for publication July 30, 1993. Address for reprints; Michael Havel, MD, Second Department of Surgery, University of Vienna, Spitalglass 23, A-1090 Wien, Austria.

Abstract

Forty-five male patients with planned coronary artery bypass operation were randomized in a double blind fashion to receive either 6 million kallikrein inactivator units of aprotinin (high-dose group), 2 million kallikrein inactivator units of aprotinin (low-dose group), or placebo (control group). Postoperative bleeding was significantly decreased in both aprotinin groups in comparison to that in the control group (590 ml [290 to 1800 ml] high-dose group and 650 ml [280 to 1900 ml] low-dose group versus 920 ml (350 to 2700 ml) control group, p < 0.001). There was no difference between the two aprotinin groups. The need for postoperative blood transfusion was significantly lower in the aprotinin groups (1.46 [0 to 4] blood units high-dose group and 1.65 [0 to 5] blood units low-dose group versus 2.43 [0 to 7] blood units control group, p < 0.05). All patients underwent coronary angiography between the seventh and twelfth postoperative day. No difference was found among the three groups in patency of vein grafts—93.8% in the high-dose group, 94.5% in the low-dose groups, and 93.3% in the control group. Therefore, aprotinin significantly reduced postoperative bleeding and transfusion requirement after coronary artery bypass grafting without influencing early graft patency. (J THORAC CARDIOVASC SURG 1994;107:807-10)




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