title: Antifibrinolytic agents in cardiac surgery: current controversies.
abstract: Antifibrinolytic agents play a prominent role in adult cardiac surgery. This article is a review of the modern published experience of antifibrinolytic agent use in adult cardiac surgery. The use of tranexamic acid, epsilon-aminocaproic acid, and aprotinin is examined during primary cardiac surgery, deep hypothermic circulatory arrest, reoperative cardiac surgery, and off-pump coronary artery bypass surgery. In addition, the issues of vein graft patency and hypersensitivity reaction in the presence of antifibrinolytic agents are examined.
authors.affiliation: Carlyle Fraser Heart Center, Division of Cardiothoracic Surgery, Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, GA 30308, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Serna
authors.forename: Vinod H
authors.initials: VH
authors.lastname: Thourani
authors.forename: John D
authors.initials: JD
authors.lastname: Puskas
mesh_terms: D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D013923:Thromboembolism / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents