TY - JOUR
T1 - Is aprotinin indicated for reoperative valvular surgery?
AU - Goldstein, Daniel J.
AU - DeRosa, Carolyn M.
AU - Seldomridge, J. Alex
AU - Weinberg, Alan D.
AU - Oz, Mehmet C.
AU - Smith, Craig R.
PY - 1997/1
Y1 - 1997/1
N2 - Background and aims of the study: While the hemostatic effect of aprotinin for patients undergoing reoperative coronary bypass is well established, it remains unclear whether these effects extend to patients undergoing reoperative valvular surgery. Methods: We examined our experience with 85 consecutive patients undergoing isolated reoperative valvular surgery with and without use of perioperative aprotinin in order to investigate differences in perioperative blood use, blood loss, bleeding complications, mortality and incidence of myocardial injury. Results: Aprotinin recipients benefitted from a significant reduction in bleeding complications, and a decrease in perioperative and in-hospital mortalities as compared with untreated patients. Anaphylactic reactions and clinically significant thromboembolic events were not observed. There was no difference in the incidence of renal dysfunction or myocardial injury among aprotinin-treated and untreated groups. Conclusions: Our results indicate that aprotinin therapy can be safely administered to patients undergoing reoperative valvular surgery. No increased incidence of anaphylactic reactions, renal dysfunction or perioperative myocardial injury was noted. The observed reductions in bleeding complications and perioperative and in-hospital mortality strongly warrant the evaluation of aprotinin for reoperative valvular surgery in a prospective fashion.
AB - Background and aims of the study: While the hemostatic effect of aprotinin for patients undergoing reoperative coronary bypass is well established, it remains unclear whether these effects extend to patients undergoing reoperative valvular surgery. Methods: We examined our experience with 85 consecutive patients undergoing isolated reoperative valvular surgery with and without use of perioperative aprotinin in order to investigate differences in perioperative blood use, blood loss, bleeding complications, mortality and incidence of myocardial injury. Results: Aprotinin recipients benefitted from a significant reduction in bleeding complications, and a decrease in perioperative and in-hospital mortalities as compared with untreated patients. Anaphylactic reactions and clinically significant thromboembolic events were not observed. There was no difference in the incidence of renal dysfunction or myocardial injury among aprotinin-treated and untreated groups. Conclusions: Our results indicate that aprotinin therapy can be safely administered to patients undergoing reoperative valvular surgery. No increased incidence of anaphylactic reactions, renal dysfunction or perioperative myocardial injury was noted. The observed reductions in bleeding complications and perioperative and in-hospital mortality strongly warrant the evaluation of aprotinin for reoperative valvular surgery in a prospective fashion.
UR - http://www.scopus.com/inward/record.url?scp=0031032453&partnerID=8YFLogxK
M3 - Article
C2 - 9044087
AN - SCOPUS:0031032453
SN - 0966-8519
VL - 6
SP - 88
EP - 92
JO - Journal of Heart Valve Disease
JF - Journal of Heart Valve Disease
IS - 1
ER -