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Clinic for Cardiovascular Surgery, University Hospital of Berne, Berne, Switzerland
* Corresponding author. Tel.: +41 31 632 23 75; fax: +41 31 632 44 43. (Email: thierry.carrel@insel.ch).
Key Words: Aprotinin Cardiac surgery Mortality Late survival
| The first 20% of the full text of this article appears below. |
Stamou and colleagues present another critical article about adverse outcome following administration of aprotinin in adult cardiac surgery [1]. In this retrospective study, haemostatic effects of aprotinin were confirmed but the authors found an increased risk for in-hospital cardiac arrest. Another intriguing finding was found, namely that the risk of late cardiac death was higher in patients who received aprotinin than after aminocaproic acid (EACA). Unfortunately, neither the cause of early mortality nor the problem of cardiac-related attrition (graft occlusion, perioperative myocardial infarction, malignant arrhythmias or others) were analysed or specified.
Because of the retrospective character of the study, several limitations and bias have to be considered: the use of aprotinin or EACA was left at the discretion of the surgeons. The patients who
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