Tranexamic acid in aortic valve replacement.
OBJECTIVE
To assess the relative efficacy of tranexamic acid compared with a control group to decrease bleeding and transfusion requirements in a uniform population undergoing aortic valve replacement.


METHODS
Prospective, randomized, double-blind study.


METHODS
University hospital.


METHODS
Adult cardiac surgery patients (n = 300).


METHODS
Patients were randomized into 2 groups to receive either a total of 5 g of tranexamic acid or a saline solution. Bleeding in the postoperative period, transfusions of bank blood products, coagulation profile, intensive care unit stay, and hospital length of stay were recorded.


RESULTS
Postoperative bleeding in patients treated with tranexamic acid was significantly lower compared with the control group (p < 0.0001). Packed red blood cells and fresh frozen plasma usage were reduced in the tranexamic acid group compared with the control group (p = 0.0095 and p < 0.0001). Only 24.5% of tranexamic acid patients received blood products versus 45% of control patients (p < 0.01). There was no significant difference in hematologic and coagulation profiles after the operation between the groups.


CONCLUSIONS
Tranexamic acid reduces postoperative blood loss and transfusion requirements in elective aortic valve replacement.
Armellin
G
G
Department of Anesthesiology and Critical Care and Venetian Tumour Registry, Padua School of Medicine, Padua, Italy.
Casella
S
S
Guzzinati
S
S
Pasini
L
L
Marcassa
A
A
Giron
G
G
D000368:Aged; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001021:Aortic Valve / Q000601:surgery*; D001772:Blood Cell Count; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D004311:Double-Blind Method; D004322:Drainage; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid