Safety and efficacy of aprotinin under conditions of deep hypothermia and circulatory arrest

Daniel J. Goldstein, Carolyn M. DeRosa, Linda B. Mongero, Alan D. Weinberg, Robert E. Michler, Eric A. Rose, Mehmet C. Oz, Craig R. Smith

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Aprotinin has been successfully used to reduce blood loss and blood product requirements in patients undergoing primary and reoperative cardiac operations. Its safety and efficacy during profound hypothermia and circulatory arrest have been questioned, however. A retrospective review compared 24 patients who received aprotinin during complex aortic procedures under profound hypothermia and circulatory arrest with 24 age-matched patients undergoing similar procedures without aprotinin. Activated clotting time was maintained at longer than 500 seconds (kaolin activating agent) or longer than 750 seconds (celite). We observed no statistically significant difference in the incidence of neurologic events ( p not significant) or myocardial infarctions ( p not significant), and there was a trend toward reduced in-hospital mortality rate in aprotinin-treated patients. A higher incidence of postoperative renal dysfunction was encountered in aprotinin-treated patients. Aprotinin recipients had a significant reduction in requirements for postoperative homologous erythrocytes ( p = 0.01). We conclude that aprotinin may be safely and effectively used in patients undergoing deep hypothermia and circulatory arrest. (J THORAC CARDIOVASC SURG 1995;110:1615-22).

Original languageEnglish (US)
Pages (from-to)1615-1621
Number of pages7
JournalThe Journal of Thoracic and Cardiovascular Surgery
Volume110
Issue number6
DOIs
StatePublished - Dec 1995
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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