IS APROTININ INDICATED FOR REOPERATIVE VALVULAR SURGERY

Background and aims of the study: While the hemostatic effect of aprot inin for patients undergoing reoperative coronary bypass is well estab lished, it remains unclear whether these effects extend to patients un dergoing reoperative valvular surgery. Methods: We examined our experi ence with 85 consecutive patients undergoing isolated reoperative valv ular surgery with and without use of perioperative aprotinin in order to investigate differences in perioperative blood use, blood loss, ble eding complications, mortality and incidence of myocardial injury. Res ults: Aprotinin recipients benefited from a significant reduction in b leeding complications, and a decrease in perioperative and in-hospital mortalities as compared with untreated patients. Anaphylactic reactio ns and clinically significant thromboembolic events were not observed. There was no difference in the incidence of renal dysfunction or myoc ardial injury among aprotinin-treated and untreated groups. Conclusion s: Our results indicate that aprotinin therapy can be safely administe red to patients undergoing reoperative valvular surgery. No increased incidence of anaphylactic reactions, renal dysfunction or perioperativ e myocardial injury was noted. The observed reductions in bleeding com plications and perioperative and in-hospital mortality strongly warran t the evaluation of aprotinin for reoperative valvular surgery in a pr ospective fashion.