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Postoperative complications following the Fontan procedure: the role of aprotinin

D Klugman1, M T Donofrio, D Zurakowski

  • 1Department of Critical Care Medicine and Cardiology, Children's National Heart Institute, Children's National Medical Center, The George Washington University School of Medicine, Washington, DC 20010, USA. dklugman@cnmc.org

Perfusion
|July 15, 2011
PubMed

Insights

Aprotinin, an anti-inflammatory drug, may reduce postoperative arrhythmias in pediatric Fontan procedure patients. This study found no increased risk of complications like prolonged chest tube drainage or renal dysfunction with aprotinin use.

Area of Science:

  • Pediatric Cardiac Surgery
  • Pharmacology
  • Inflammation

Background:

  • The Fontan procedure is a complex surgery for single-ventricle congenital heart defects.
  • Postoperative complications, including arrhythmias, can significantly impact outcomes in these patients.
  • Aprotinin's anti-inflammatory properties suggest a potential role in mitigating surgical stress and complications.

Purpose of the Study:

  • To investigate the impact of aprotinin on postoperative complications in children undergoing the Fontan procedure.
  • To assess whether aprotinin reduces the incidence of arrhythmias and other adverse events.
  • To evaluate the safety of aprotinin concerning chest tube drainage, renal function, and thrombosis.

Main Methods:

  • Retrospective cohort study comparing 56 pediatric patients undergoing the Fontan procedure.
  • Study group (n=29) received aprotinin; control group (n=27) did not.
  • Primary outcome measures included duration and volume of chest tube drainage; secondary outcomes included arrhythmias, renal function, and thrombosis.

Main Results:

  • Aprotinin administration was significantly associated with decreased postoperative arrhythmias (P=0.01).
  • No significant differences were observed in renal function, fenestration or Fontan thrombosis between groups.
  • There was no statistically significant difference in the volume or duration of chest tube drainage.

Conclusions:

  • Aprotinin's anti-inflammatory effects may offer protection against postoperative arrhythmias in pediatric Fontan patients.
  • Aprotinin does not appear to increase the risk of prolonged chest tube drainage, renal dysfunction, or thrombosis.
  • Aprotinin is a potentially beneficial adjunct in managing postoperative complications after the Fontan procedure.
Abstract

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