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Is aprotinin indicated for reoperative valvular surgery?
D J Goldstein1, C M DeRosa, J A Seldomridge
1Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
The Journal of Heart Valve Disease
|January 1, 1997
Summary
Aprotinin (a drug to reduce bleeding) significantly lowered bleeding complications and mortality in reoperative valvular surgery patients. This study found aprotinin safe for these patients, with no increased risk of adverse events.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Pharmacology
Background:
- Aprotinin's hemostatic benefits are known for reoperative coronary bypass.
- Its efficacy in reoperative valvular surgery is not well-established.
Purpose of the Study:
- To investigate the safety and efficacy of aprotinin in patients undergoing reoperative valvular surgery.
- To compare perioperative blood use, blood loss, bleeding complications, mortality, and myocardial injury in patients with and without aprotinin.
Main Methods:
- Retrospective analysis of 85 consecutive patients undergoing isolated reoperative valvular surgery.
- Comparison of outcomes between patients who received perioperative aprotinin and those who did not.
Main Results:
- Aprotinin group showed significant reductions in bleeding complications and perioperative/in-hospital mortality.
- No increase in anaphylactic reactions, thromboembolic events, renal dysfunction, or myocardial injury was observed.
- No significant difference in perioperative blood use or blood loss was noted.
Conclusions:
- Aprotinin can be safely administered to patients undergoing reoperative valvular surgery.
- The drug demonstrated significant reductions in bleeding and mortality without increasing adverse events.
- Prospective evaluation of aprotinin for reoperative valvular surgery is warranted.