Universität zu Köln

Madershahian, Navid, Scherner, Maximilian, Pfister, Roman, Rudolph, Tanja, Deppe, Antje C., Slottosch, Ingo, Kuhn, Elmar, Choi, Yeong-Hoon and Wahlers, Thorsten (2015). Prophylactic intraoperative tranexamic acid administration and postoperative blood loss after transapical aortic valve implantation. J. Cardiothorac. Surg., 10. LONDON: BIOMED CENTRAL LTD. ISSN 1749-8090

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-404636
DOI:	10.1186/s13019-015-0246-5
Journal or Publication Title:	J. Cardiothorac. Surg.
Volume:	10
Date:	2015
Publisher:	BIOMED CENTRAL LTD
Place of Publication:	LONDON
ISSN:	1749-8090
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARDIOPULMONARY BYPASS; DOUBLE-BLIND; CORONARY SURGERY; CARDIAC-SURGERY; TRANSCATHETER; COMPLICATIONS; OUTCOMES; TRANSFUSIONS; REPLACEMENT; PROSTHESIS Multiple languages Cardiac & Cardiovascular Systems; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40463