TITLE:
Redo Cardiac Surgery: Bleeding Control
AUTHORS:
A. Seghrouchni, M. Bamous, Y. Moutakiallah, F. Nya, N. Atmani, A. Abdou, M. Belkhadir, S. Bellouize, A. Abetti, R. Mounir, A. Moujahid, A. G. Hatim, M. Drissi, Y. El Bekkali, A. Boulahya, M. Ait. Houssa
KEYWORDS:
Cardiac Surgery, Aprotinin, Tranexamic Acid, Cardiopulmonary Bypass
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.7 No.9,
September
25,
2017
ABSTRACT: Redo cardiac surgery increasesmortality and morbidity. The aim of this study was to determine if aprotinin was superior to tranexamic acid concerning control bleeding loss after redo valve surgery. A retrospective study was conducted from January 1994 until December 2014. 221 patients underwent redo cardiac valve surgery and separated into two groups: aprotinin group (n=85) and tranexamic acid group (n=136). Univariate tests were applied for data analysis. A total of 221 patients were enrolled in this study. This cohort was separated into two groups: aprotinin group (n=85) and tranexamic acid group (n=136). Euroscore in tranexamic acid group was higher: 5.96 ± 3.04 vs.5.17 ± 2.83 in aprotinin group(p=0.055). There was no statistical difference in postoperative mortality between the two groups (p= 0.153). No statistical differences were reported concerning: total blood loss (p= 0.51), red blood cells transfusion (p= 0.215), reexploration for bleeding (p= 0.537) and postoperative renal failure (p= 0.79). There were statistical differences concerning mechanical ventilation time, which is longer in tranexamic acid group (p= 0.008) and the use of inotropic drug support, which is more frequent in the tranexamic acid group (p= 0.001). Our results demonstrated that tranexamic acid and aprotinin reduce transfusion requirement and blood loss. Due to financial reason, we chose tranexamic acid in preventing blood loss in redo valve surgery.