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Tranexamic acid in aortic valve replacement
G Armellin1, S Casella, S Guzzinati
1Department of Anesthesiology and Critical Care and Venetian Tumour Registry, Padua School of Medicine, Padua, Italy.
Objective:
To assess the relative efficacy of tranexamic acid compared with a control group to decrease bleeding and transfusion requirements in a uniform population undergoing aortic valve replacement.
Design:
Prospective, randomized, double-blind study.
Settings:
University hospital.
Participants:
Adult cardiac surgery patients (n = 300).
Interventions:
Patients were randomized into 2 groups to receive either a total of 5 g of tranexamic acid or a saline solution. Bleeding in the postoperative period, transfusions of bank blood products, coagulation profile, intensive care unit stay, and hospital length of stay were recorded.
Measurements And Main Results:
Postoperative bleeding in patients treated with tranexamic acid was significantly lower compared with the control group (p < 0.0001). Packed red blood cells and fresh frozen plasma usage were reduced in the tranexamic acid group compared with the control group (p = 0.0095 and p < 0.0001). Only 24.5% of tranexamic acid patients received blood products versus 45% of control patients (p < 0.01). There was no significant difference in hematologic and coagulation profiles after the operation between the groups.
Conclusions:
Tranexamic acid reduces postoperative blood loss and transfusion requirements in elective aortic valve replacement.