Strategy for balancing anticoagulation and hemostasis in aortocoronary bypass surgery - Blood conservation and graft patency -

K. Hashimoto, K. Onoguchi, T. Sasaki, T. Hachiya, H. Takakura, R. Nagahori, S. Takeuchi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The minimal effective dose of aprotinin on hemostasis under normothermic perfusion, the influence of anticoagulant therapy on graft patency, and the thromboembolic and hemorrhagic events were investigated after aortocoronary bypass graft operation (CABG). One hundred CABG patients under normothermic perfusion were randomly divided into the following groups: (1) coumadin plus acetylsalicylic acid (ASA) (n=32); no aprotinin used during cardiopulmonary bypass (CPB); (2) minimal-dose, 106 KIU during CPB, aprotinin used, followed by ASA and coumadin (n=36); and (3) very low-dose, total of 2x106 KIU before CPB and during CPB; aprotinin used; anticoagulation therapy with heparin early after surgery and followed by replacement with ASA and coumadin (n=32). The patency of arterial grafts was 100% in all groups. The patency of vein grafts was 95-98% and there was no difference among the groups. The blood loss was significantly reduced in both aprotinin groups (groups 2 and 3) compared to the coumadin plus ASA group, although no difference existed between the 2 aprotinin groups. Postoperative thrombotic and hemorrhagic events were not observed in any group. From this study, it was concluded that 106 KIU aprotinin in pump-prime-only followed by oral ASA and coumadin was the recommendation from the benefit/cost consideration.

Original languageEnglish
Pages (from-to)165-169
Number of pages5
JournalJapanese Circulation Journal
Volume63
Issue number3
DOIs
Publication statusPublished - 1999

Fingerprint

Aprotinin
Hemostasis
Coronary Artery Bypass
Warfarin
Transplants
Aspirin
Cardiopulmonary Bypass
Perfusion
Anticoagulants
Cost-Benefit Analysis
Heparin
Veins
Therapeutics

Keywords

  • Anticoagulation
  • Aortocoronary bypass surgery
  • Aprotinin
  • Cardiopulmonary bypass

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Strategy for balancing anticoagulation and hemostasis in aortocoronary bypass surgery - Blood conservation and graft patency -. / Hashimoto, K.; Onoguchi, K.; Sasaki, T.; Hachiya, T.; Takakura, H.; Nagahori, R.; Takeuchi, S.

In: Japanese Circulation Journal, Vol. 63, No. 3, 1999, p. 165-169.

Research output: Contribution to journalArticle

Hashimoto, K, Onoguchi, K, Sasaki, T, Hachiya, T, Takakura, H, Nagahori, R & Takeuchi, S 1999, 'Strategy for balancing anticoagulation and hemostasis in aortocoronary bypass surgery - Blood conservation and graft patency -', Japanese Circulation Journal, vol. 63, no. 3, pp. 165-169. https://doi.org/10.1253/jcj.63.165
Hashimoto, K. ; Onoguchi, K. ; Sasaki, T. ; Hachiya, T. ; Takakura, H. ; Nagahori, R. ; Takeuchi, S. / Strategy for balancing anticoagulation and hemostasis in aortocoronary bypass surgery - Blood conservation and graft patency -. In: Japanese Circulation Journal. 1999 ; Vol. 63, No. 3. pp. 165-169.
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