Safety of Aprotinin Under Hypothermic Circulatory Arrest.
- Author:
Byung Chul CHANG
1
;
Joung Taek KIM
;
Young Lan KWAK
;
Shi Ho KIM
;
Kyung Jong YOO
;
Che Hyuk LEE
;
Yong Woo HONG
Author Information
1. Yonsei Cardiovascular Center, Division of Cardiovascular Surgery, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Total circulatory arrest, induced;
Aprotinin;
Renal failure, acute;
Activated clotting time
- MeSH:
Acute Kidney Injury;
Aged;
Aorta, Thoracic;
Aprotinin*;
Arteries;
Carotid Arteries;
Cerebral Infarction;
Circulatory Arrest, Deep Hypothermia Induced;
Coronary Vessels;
Femoral Artery;
Hemorrhage;
Hospitalization;
Humans;
Myocardial Infarction;
Perfusion;
Stroke
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1997;30(5):501-505
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
It was reported that use of aprotinin in elderly patients undergoing hypothermic circulatory arrest was associated with an increased risk of renal dysfunction, and myocardial infarction as a result of intravascular coagulation. We reviewed 20 patients who received high-dose aprotinin under deep hypothermic circulatory arrest with(NP group, n=11) or without selective cerebral perfusion(SP group, n=9). The activated clotting time was exceeded 750 seconds in all but 1 patient. After opening aortic arch, retrograde low flow perfusion was maintained through femoral artery to prevent air embolization to the visceral arteries. Four patients among 20 died during hospitalization due to bleeding, coronary artery dissection, pulmonary hemorrhage and multiple cerebral infarction. Postoperatively, cerebrovascular accidents occurred in two patients; one with preoperative carotid artery dissection and the other with unknown multiple cerebral infarction. In conclusion, use of aprotinin in young patients undergoing hypothermic circulatory arrest did not increase the risk of renal dysfunction or intravascular coagulation if ACT during circulatory arrest is maintained to exceed 750 seconds with low-flow perfusion.
