Antifibrinolytic agents in cardiac surgery: Current controversies

Seminars in Thoracic and Cardiovascular Surgery

Volumn 17, Issue 1, 2005, Pages 52-58

  Serna, Daniel L ^a   Thourani, Vinod H ^a   Puskas, John D ^a,b  

^a EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Antifibrinolytic; Aprotinin; Cardiac surgery; Cardiopulmonary bypass; Circulatory arrest

Indexed keywords

AMINOCAPROIC ACID; ANTIFIBRINOLYTIC AGENT; APROTININ; BETA 2 MICROGLOBULIN; CREATININE; HEPARIN; N ACETYL BETA GLUCOSAMINIDASE; NITROGEN; PLACEBO; TRANEXAMIC ACID; UREA;

BLOOD CLOTTING DISORDER; BLOOD TRANSFUSION; CLINICAL EXAMINATION; CLINICAL PROTOCOL; CLINICAL TRIAL; DRUG UTILIZATION; EXPERIENCE; GRAFT PATENCY; HEART ARREST; HEART INFARCTION; HEART SURGERY; HEART VALVE SURGERY; HUMAN; HYPERSENSITIVITY REACTION; KIDNEY DYSFUNCTION; LUNG EMBOLISM; META ANALYSIS; OFF PUMP CORONARY SURGERY; POSTOPERATIVE HEMORRHAGE; POSTOPERATIVE THROMBOSIS; REOPERATION; REVIEW; STROKE; SYSTEMATIC REVIEW; TREATMENT OUTCOME; VEIN GRAFT;

ANTIFIBRINOLYTIC AGENTS; CARDIAC SURGICAL PROCEDURES; CARDIOPULMONARY BYPASS; CARDIOVASCULAR DISEASES; CORONARY ARTERY BYPASS; DOSE-RESPONSE RELATIONSHIP, DRUG; DRUG ADMINISTRATION SCHEDULE; FEMALE; HEART VALVE PROSTHESIS IMPLANTATION; HUMANS; MALE; PERIOPERATIVE CARE; POSTOPERATIVE COMPLICATIONS; PROGNOSIS; RANDOMIZED CONTROLLED TRIALS; RISK ASSESSMENT; SEVERITY OF ILLNESS INDEX; SURVIVAL ANALYSIS; THROMBOEMBOLISM; TREATMENT OUTCOME;

EID: 17144387495     PISSN: 10430679     EISSN: None     Source Type: Journal    
DOI: 10.1053/j.semtcvs.2004.11.004     Document Type: Review

References (53)

1. R.Y. Dodd The risk of transfusion-transmitted infection N Engl J Med 327 1992 419-421
2. P. Murphy C. Connery G. Hicks et al. Homologous blood transfusions as a risk factor for postoperative infection after coronary artery bypass operations J Thorac Cardiovasc Surg 104 1992 1092-1099
3. L. Dacey J. Munoz Y. Baribeau et al. Reexploration for hemorrhage following coronary artery bypass grafting: Incidence and risk factors Arch Surg 133 1998 442-447
4. M. Moulton L. Creswell M. Mackey et al. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations J Thorac Cardiovasc Surg 111 1996 1037-1046
5. R. Woodman L. Harker Bleeding complications associated with cardiopulmonary bypass Blood 76 1990 1680-1697
6. E. Boyle E. Verrier B. Spiess Endothelial cell injury in cardiovascular surgery: The procoagulant response Ann Thorac Surg 62 1996 1549-1557
7. M. Ray N. Marsh G. Hawson Relationship of fibrinolysis and platelet function to bleeding after cardiopulmonary bypass Blood Coagul Fibrinolysis 5 1994 679-685
8. E. Levin D. Stern P. Nawroth et al. Specificity of the thrombin-induced release of tissue plasminogen activator from cultured human endothelial cells Thromb Haemost 56 1986 115-119
9. M. Verstraete Clinical application of inhibitors of fibrinolysis Drugs 29 1985 236-261
10. J. Horrow J. Hlavacek M. Strong et al. Prophylactic tranexamic acid decreased bleeding after cardiac operations J Thorac Cardiovasc Surg 99 1990 70-74
11. J. Horrow D. van Riper M. Strong et al. The hemostatic effects of tranexamic acid and desmopressin during cardiac surgery Circulation 84 1991 2063
12. J.M. Karski S. Teasdale P. Norman et al. Prevention of post bypass bleeding with tranexamic acid and epsilon-aminocaproic acid J Cardiothorac Vasc Anesth 7 1993 431-435
13. A. DelRossi A. Cernaianu S. Bostros et al. Prophylactic treatment of post perfusion bleeding using EACA Chest 96 1989 27-30
14. P. Daily J. Lamphere W. Dembitsky Effect of prophylactic epsilon-aminocaproic acid on blood loss and transfusion requirements in patients undergoing first-time coronary artery bypass grafting J Thorac Cardiovasc Surg 108 1994 99-108
15. D. Jordan E. Delphin E. Rose Prophylactic epsilon-aminocaproic acid (EACA) administration minimizes blood replacement therapy during cardiac surgery Anesth Analg 80 1995 827-829
16. R. Kluger D.J. Olive A.B. Stewart et al. Epsilon-aminocaproic acid in coronary artery bypass graft surgery: Preincision or postheparin? Anesthesiology 99 2003 1263-1269
17. P. Mongan R. Brown B. Thwaites Tranexamic acid and aprotinin reduced postoperative bleeding and transfusions during primary coronary revascularizations Anesth Analg 87 1998 258-256
18. V. Casati D. Guzzon M. Oppizzi et al. Hemostatic effects of aprotinin, tranexamic acid and ε-aminocaproic acid in primary cardiac surgery Ann Thorac Surg 68 1999 2252-2257
19. M. Levi M. Cromheecke E. de Jonge et al. Pharmacologic strategies to decrease excessive blood loss in cardiac surgery: A meta-analysis of clinically relevant endpoints Lancet 354 1999 1940-1947
20. J.J. Munoz N. Birkmeyer J. Birkmeyer et al. Is epsilon-aminocaproic acid as effective as aprotinin in reducing bleeding with cardiac surgery? A meta-analysis Circulation 99 1999 81-89
21. V. Casati D. Guzzon M. Oppizzi et al. Tranexamic acid compared with high-dose aprotinin in primary elective heart operation: Effects of perioperative bleeding and allogeneic transfusions J Thorac Cardiovasc Surg 120 2000 520-527
22. T.M. Sundt III N.T. Kouchoukos J.E. Saffitz et al. Renal dysfunction and intravascular coagulation with aprotinin and hypothermic circulatory arrest Ann Thorac Surg 55 1993 1418-1424
23. J.E. Saffitz D.J. Stahl T.M. Sundt et al. Disseminated intravascular coagulation after administration of aprotinin in combination with deep hypothermic circulatory arrest Am J Cardiol 72 1993 1080-1082
24. S. Westaby A. Forni J. Dunning et al. Aprotinin and bleeding in profoundly hypothermic perfusion Eur J Cardiothorac Surg 8 1994 82-86
25. I.A. Regragui A.J. Bryan M.B. Izzat et al. Aprotinin use with hypothermic circulatory arrest for aortic valve and thoracic aortic surgery: Renal function and early survival J Heart Valve Dis 4 1995 674-677
26. S.J. Rooney D. Pagano G. Bognolo et al. Aprotinin in aortic surgery requiring profound hypothermia and circulatory arrest Eur J Cardiothorac Surg 11 1997 373-378
27. G. Godet M.H. Fleron E. Vicaut et al. Risk factors for acute postoperative renal failure in thoracic or thoracoabdominal aortic surgery: A prospective study Anesth Analg 85 1997 1227-1232
28. Y. Okita S. Takamoto M. Ando et al. Coagulation and fibrinolysis system in aortic surgery under deep hypothermic circulatory arrest with aprotinin Circulation 96 Suppl 1997 II376-II381
29. D.J. Goldstein C.M. DeRosa L.B. Mongero et al. Safety and efficacy of aprotinin under condition of deep hypothermia and circulatory arrest J Thorac Cardiovasc Surg 110 1995 1615-1622
30. P.W. Seigne G.D. Shorten R.G. Johnson et al. The effects of aprotinin on blood product transfusion associated with thoracic aortic surgery requiring deep hypothermic circulatory arrest J Cardiothorac Vasc Anesth 14 2000 676-681
31. C.T. Mora Mangano M.J. Nevillle P.H. Hsu et al. Aprotinin, blood loss, and renal dysfunction in deep hypothermic circulatory arrest Circulation 104 2001 I276-I281
32. M. Ehrlich M. Grabenwoger F. Cartes-Zumelzu et al. Operation on the thoracic aorta and hypothermic circulatory arrest: Is aprotinin safe? J Thorac Cardiovasc Surg 115 1998 220-225
33. V. Casati L. Sandrelli G. Speziali et al. Hemostatic effects of tranexamic acid in elective thoracic aortic surgery: A prospective, randomized, double-blind, placebo-controlled study J Thorac Cardiovasc Surg 123 2002 1084-1091
34. M.P. Fanashawe L. Shore-Lesserson D.L. Reich Two cases of fatal thrombosis after aminocaproic acid therapy and deep hypothermic circulatory arrest Anesthesiology 95 2001 1525-1527
35. M.P. Eaton G.M. Deeb Aprotinin versus epsilon-aminocaproic acid for aortic surgery using deep hypothermic circulatory arrest J Cardiothorac Vasc Anesth 12 1998 548-555
36. V. Casati C. Gerli A. Franco et al. Tranexamic acid in off-pump coronary surgery: A preliminary, randomized, double-blind, placebo controlled study Ann Thorac Surg 72 2001 470-475
37. L. Englberger P. Markart F.S. Eckstein et al. Aprotinin reduces blood loss in off-pump coronary artery bypass (OPCAB) surgery Eur J Cardiothorac Surg 22 2002 545-551
38. D.M. Cosgrove III B. Heric B.W. Lytle et al. Aprotinin therapy for re-operative myocardial revascularization: A placebo-controlled study Ann Thorac Surg 54 1992 1031-1038
39. E. Alderman J. Levy J. Rich et al. Analyses of coronary graft patency after aprotinin use: Results from the international multicenter aprotinin graft patency experience (IMAGE) trial J Thorac Cardiovasc Surg 116 1998 716-730
40. J. Levy Pharmacologic preservation of the hemostatic system during cardiac surgery Ann Thorac Surg 72 2001 S1814-S1820
41. R. Landis G. Asimakopoulos M. Poullis et al. The antithrombotic and anti-inflammatory mechanisms of action of aprotinin Ann Thorac Surg 72 2001 2169-2175
42. M. Havel F. Grabenwoger J. Schneider et al. Aprotinin does not decrease early graft patency after coronary artery bypass grafting despite reducing postoperative bleeding and use of donated blood J Thorac Cardiovasc Surg 107 1994 807-811
43. A. Parolari C. Antona P. Gerometta et al. The effect of "high dose" aprotonin and other factors on bleeding and revisions for bleeding in adult coronary and valve operations: An analysis of 2190 patients during a five-year period (1987-1991) Eur J Cardiothorac Surg 9 1995 77-82
44. M.N. D'Ambra C.W. Akins E.H. Blackstone et al. Aprotinin in primary valve replacement and reconstruction: A multicenter double-blind, placebo-controlled trial J Thorac Cardiovasc Surg 112 1996 1081-1089
45. M.J. Ray N.A. Marsh S.J.E. Just et al. Preoperative platelet dysfunction increases the benefit of aprotonin in cardiopulmonary bypass Ann Thorac Surg 63 1997 57-63
46. T. Miyashita T. Kamibayashi Y. Ohnishi et al. Preservation of collagen-induced whole blood platelet aggregation by tranexamic acid therapy in primary cardiac valve surgery Perfusion 15 2000 507-513
47. B.I. Wong R.F. McLean S.E. Fremes et al. Aprotinin and tranexamic acid for high transfusion risk cardiac surgery Ann Thorac Surg 69 2000 808-816
48. G. Armellin S. Casella S. Guzzinati et al. Tranexamic acid in aortic valve replacement J Cardiothorac Vasc Anes 15 2001 331-335
49. D.K. Tempe A. Banerjee S. Virmani et al. Comparison of the effects of a cell saver and low-dose aprotonin on blood loss and homologous blood usage in patients undergoing valve surgery J Cardiothorac Vasc Anes 15 2001 326-330
50. G.A. Nuttall W.C. Oliver Jr M.H. Ereth et al. Comparison of blood-conservation strategies in cardiac surgery patients at high risk for bleeding Anesthesiology 92 2000 674-682
51. C.F. Kirzner A.R. Correia O.M. Azevedo Jr et al. Low-dose aprotonin in heart valve reoperations J Heart Valve Dis 10 2001 222-227
52. B. Blauhunt C. Gross S. Necek et al. Effects of high-dose aprotinin on blood loss, platelet function, fibrinolysis, complement, and renal function after cardiopulmonary bypass J Thorac Cardiovasc Surg 101 1991 958-967
53. W. Dietrich P. Spath M. Zuhlsdorf et al. Anaphylactic reactions to aprotinin reexposure in cardiac surgery relation to antiaprotinin immunoglobulin G and E antibodies Anesthesiology 95 2001 64-71