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J Thorac Cardiovasc Surg 1994;108:517-521
© 1994 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

Aprotinin in children undergoing correction of congenital heart defectsA double-blind pilot study

Porto Alegre, Brazil

From the Department of Cardiac Surgery, Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil.

Received for publication April 9, 1993. Accepted for publication Jan. 28, 1994. Address for reprints: F. Herynkopf, MD, Department of Cardiac Surgery, Instituto de Cardiologia do Rio Grande do Sul, Av. Princesa Isabel, 395, Porto Alegre, RS, Brasil - 90.620-001.

Abstract

Thirty children undergoing surgical repair for congenital heart defects were randomly selected for a double-blind study on the antihemorrhagic and blood-saving properties of aprotinin. The treatment group comprised 14 patients who received aprotinin 7 mg/kg of body weight until the end of perfusion. The placebo group (n = 16) received an infusion of the corresponding volumes of saline. Patients treated with aprotinin bled less during the operation (12.6 ml/kg versus 18.1 ml/kg, p = 0.25) and in the first 24 postoperative hours (chest drainage 12.1 ml/kg versus 17.7 ml/kg, p = 0.07). Hemoglobin loss into chest drainage was reduced in the treated group by half (0.66 versus 1.21 gm in 24 hours, p = 0.07). Fewer blood donors were needed during hospitalization by patients receiving aprotinin (1.07 versus 2.75 donors per patient, p = 0.04). Postoperative transfusion was unnecessary in 64.2% of patients receiving aprotinin compared with only 25% of the placebo group (p = 0.03). Aprotinin increased diuresis significantly during perfusion (4.3 ml/kg versus 1.0 ml/kg, p = 0.005). Other parameters are evaluated, and considerations are made regarding adequacy of the dosage regimen. The drug seems to be safe and easy to handle in children. (J THORAC CARDIOVASCSURG 1994;108:517-21)

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