A. Kalangos et al., INFLUENCE OF APROTININ ON EARLY GRAFT THROMBOSIS IN PATIENTS UNDERGOING MYOCARDIAL REVASCULARIZATION, European journal of cardio-thoracic surgery, 8(12), 1994, pp. 651-656
One hundred sixty-five patients undergoing primary myocardial revascul
arization were prospectively entered into a randomized, double-blind,
placebo-controlled study, in a single institution, in order to determi
ne the influence of high- and low-dose aprotinin application on early
coronary artery bypass graft patency. All patients were operated on by
the same team and the three treatment groups were comparable in all d
emographic data and surgical variables. Postoperative chest tube drain
age and transfusion requirements were significantly reduced in patient
s receiving high or low doses of aprotinin. In all patients vein and i
nternal mammary artery graft patency was assessed by control coronary
angiograms 4 to 15 days (median 8.2 days) postoperatively. In the high
-dose aprotinin group, 140 of 142 vein grafts and in the low-dose apro
tinin group all of the 128 vein grafts were patent compared with 138 o
f 139 in the placebo group. The difference was not statistically signi
ficant (P > 0.05). All pedicled internal mammary artery grafts were pa
tent in the three treatment groups. The prevalence of perioperative my
ocardial infarction was evaluated by serial creatine kinase-myocardial
band (CK-MB) isoenzyme measurements and by electrocardiographic recor
dings. No additional changes that could be attributed to aprotinin wer
e observed. In conclusion, these results suggest that perioperative my
ocardial infarction secondary to aprotinin-induced native coronary art
ery or conduit thrombosis is not increased by aprotinin in patients un
dergoing primary myocardial revascularization.