Local administration of tranexamic acid in off-pump coronary artery bypass

We administered tranexamic acid locally to patients undergoing off-pump coronary artery bypass, to investigate the hemostatic effects and safety.

The subjects were 100 consecutive patients who underwent off-pump coronary artery bypass between July 2009 and January 2011. We assigned 50 patients in the early phase, in which tranexamic acid was not employed, to group N, and 50 in the late phase, in which tranexamic acid was employed, to group T. In group T, 10 mL of a solution containing 1 g of tranexamic acid in was sprayed into the pericardial cavity and mediastinum before the sternum was closed. We compared the volume of postoperative blood loss, blood transfusion volume, and complications between the 2 groups.

The volume of blood loss in 24 h after intensive care unit admission was 492 mL in group N and 303 mL in group T (p<0.0001); the decrease in blood loss in the group receiving tranexamic acid was approximately 40%. There was no significant difference in the blood transfusion volumes. There were no side effects of tranexamic acid.

In patients undergoing off-pump coronary artery bypass, local administration of tranexamic acid may decrease the volume of postoperative blood loss. The local administration method is simple, inexpensive, and safe.