Prophylactic intraoperative tranexamic acid administration and postoperative blood loss after transapical aortic valve i
- PDF / 565,107 Bytes
- 6 Pages / 595.276 x 793.701 pts Page_size
- 100 Downloads / 198 Views
RESEARCH ARTICLE
Open Access
Prophylactic intraoperative tranexamic acid administration and postoperative blood loss after transapical aortic valve implantation Navid Madershahian1*†, Maximilian Scherner1†, Roman Pfister2, Tanja Rudolph2, Antje C Deppe1, Ingo Slottosch1, Elmar Kuhn1, Yeong-Hoon Choi1† and Thorsten Wahlers1†
Abstract Objectives: Antifibrinolytics are widely used in cardiac surgery to save blood perioperatively. In the present study we evaluated the hemostatic effects of tranexamic acid (TXA) to decrease bleeding tendency and transfusion requirements in high-risk patients following transapical aortic valve implantation (TA-AVI). Methods: A retrospective analysis was performed on aortic stenosis patients undergoing TA-AVI with or without intraoperative TXA administration to determine postoperative blood loss and transfusion requirements. From January 2009 to August 2010 in total 92 patients were treated without intraoperative TXA administration, from August 2010 to July 2011 54 patients received TXA intraoperatively. Results: Early postoperative (24 h) blood loss was significantly lower in TXA-group than in non-TXA group (327 ± 274 mL vs. 481.1 ± 318.8 mL; p = 0.003). In the TXA group 53.7% of patients received allogeneic blood products during the hospital stay as compared to 72.8% in the non-TXA group (p = 0.242). TXA group required fewer transfusions (2.1 ± 1.9 vs. 2.9 ± 3.5 Units; p = 0.046) and had no increased incidence of thrombotic or neurological complications. There was no significant difference in the length of ICU, hospital stay, or 30-day mortality. Administration of tranexamic acid was found to be significantly associated with lower blood loss postoperatively (p = 0.002). Furthermore, there was a significant correlation between the postoperative blood loss (p = 0.036) and red blood cell transfusion (p = 0.001) with 30-day mortality. Conclusion: Low dose prophylactic intraoperative administration of tranexamic acid appears to be effective in reducing postoperative bleeding and the need for allogeneic blood products following TA-AVI. Keywords: Aortic valve stenosis, Tranexamic acid, Blood loss, Blood transfusion
Background At present the majority of cardiac surgical procedures are performed with extracorporeal circulation support. Excessive perioperative bleeding is most common among the well-known complications of cardiopulmonary bypass (CPB) [1]. Off-pump surgery is associated with a reduced frequency of hemorrhagic disorders. Homologous blood transfusion is commonly used to correct blood loss in surgical patients. However, it is * Correspondence: [email protected] † Equal contributors 1 Department of Cardiothoracic Surgery, Cologne University Heart Center, Kerpener Strasse 62, D-50937 Cologne, Germany Full list of author information is available at the end of the article
associated with a risk of infection, viral transmission, fluid overload and high costs [2]. Today, anti-fibrinolytic drugs are widely used, particularly in cardiac surgery. Previous reviews have confirm
Data Loading...
