HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lass, M. Articles by Hannekum, A. Search for Related Content PubMed PubMed Citation Articles by Lass, M. Articles by Hannekum, A.

European Journal of Cardio-Thoracic Surgery, Vol 9, 206-210, Copyright © 1995 by European Association for Cardio-thoracic Surgery

ARTICLES

Aprotinin in elective primary bypass surgery. Graft patency and clinical efficacy

M Lass, A Welz, M Kochs, G Mayer, M Schwandt and A Hannekum
Department for Cardiac Surgery, University of Ulm, Germany.

The proteinase inhibitor aprotinin is used in open heart surgery to reduce intraoperative and postoperative blood loss and transfusion requirements. To investigate a possible influence on graft patency, a randomized double-blind group comparison study was carried out in male patients elected for primary bypass surgery. One hundred ten (55/55) patients received either placebo treatment or aprotinin according to the Hammersmith scheme (2 Mio KIU as loading dose before sternotomy, followed by an infusion of 0.5 Mio KIU/h until the end of surgery; 2 Mio KIU added to the priming volume additionally). Graft patency was evaluated by angiography in 44 aprotinin and 35 placebo patients between the 18th and 35th days postoperatively. There was no difference in the overall graft occlusion: in the aprotinin group 89.5% (111/124) grafts were found patent compared to 87.2% (89/102) in the placebo group. Of the aprotinin patients 72.7% (32/44) and 71.4% (25/35) of the placebo patients had all grafts patent. Venous grafts were occluded in 16% (7/44) of aprotinin patients and in 29% (10/35) of placebo patients. On the other hand 5/27 patients in the aprotinin group vs 0/27 in the placebo group had occluded internal mammary artery (IMA) grafts (P = 0.0511%). Graft occlusions were not accompanied by signs of myocardial infarction in any case. Fifty-one patients in the aprotinin group and 47 patients in the placebo group were valid for parameters of clinical efficacy: blood loss within 6 h postoperatively was reduced by 58.5% in the aprotinin group (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				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]

				S. C. Body and C. D. Mazer Pro: Aprotinin Has a Good Efficacy and Safety Profile Relative to Other Alternatives for Prevention of Bleeding in Cardiac Surgery Anesth. Analg., December 1, 2006; 103(6): 1354 - 1359. [Full Text] [PDF]

				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]

				M. Kalkat, A. Levine, and J. Dunning Does use of aprotinin in coronary artery bypass graft surgery affect graft patency? Interactive CardioVascular and Thoracic Surgery, March 1, 2004; 3(1): 124 - 128. [Abstract] [Full Text] [PDF]

				R. C. Landis, G. Asimakopoulos, M. Poullis, D. O. Haskard, and K. M. Taylor The antithrombotic and antiinflammatory mechanisms of action of aprotinin Ann. Thorac. Surg., December 1, 2001; 72(6): 2169 - 2175. [Abstract] [Full Text] [PDF]

				R. C. Landis, D. O. Haskard, and K. M. Taylor New antiinflammatory and platelet-preserving effects of aprotinin Ann. Thorac. Surg., November 1, 2001; 72(5): S1808 - 1813. [Abstract] [Full Text] [PDF]

				A. Graham and H. O’Kane Is a high hematocrit value an independent risk factor for adverse outcome after coronary artery bypass grafting? J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 765 - 765. [Full Text]

				L. Shore-Lesserson, H. E. Manspeizer, M. DePerio, S. Francis, F. Vela-Cantos, and M. A. Ergin Thromboelastography-Guided Transfusion Algorithm Reduces Transfusions in Complex Cardiac Surgery Anesth. Analg., February 1, 1999; 88(2): 312 - 312. [Abstract] [Full Text] [PDF]

				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]

				J. B. Rich The efficacy and safety of aprotinin use in cardiac surgery Ann. Thorac. Surg., November 1, 1998; 66(90050): S6 - 11. [Abstract] [Full Text] [PDF]

				P. M. Mannucci Hemostatic Drugs N. Engl. J. Med., July 23, 1998; 339(4): 245 - 253. [Full Text] [PDF]

				S. Westaby Aprotinin Fifteen Years Later Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 1997; 1(4): 366 - 375. [Abstract] [PDF]

				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]