title: Administration of high-dose aprotinin during nonprimary cardiovascular surgery: case reports and review of the literature.
abstract: The perioperative management of two patients undergoing complex "redo" cardiac surgical procedures are presented. The management of both patients included the prophylactic administration of aprotinin via a "compassionate use" protocol. Aprotinin, a serine protease inhibitor, has been shown to limit the exposure to blood and blood products in patients undergoing high-risk cardiac surgical procedures. In late December 1993, the Food and Drug Administration approved aprotinin for administration to cardiac surgical patients considered at high risk for post-cardiopulmonary bypass coagulopathies. Indications for the administration of aprotinin, as well as a brief review of the literature relating to the perioperative administration of aprotinin, are included.
authors.affiliation: Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas 75235-9068.
authors.forename: C W
authors.initials: CW
authors.lastname: Whitten
authors.forename: P M
authors.initials: PM
authors.lastname: Allison
authors.forename: L M
authors.initials: LM
authors.lastname: Morse
authors.forename: T W
authors.initials: TW
authors.lastname: Latson
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000601:surgery; D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D017277:Drug Approval; D005260:Female; D006350:Heart Valve Prosthesis; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D006490:Hemostatics; D007611:Aprotinin