Aprotinin in cardiac surgery

Expert Review of Cardiovascular Therapy
Neel R SodhaFrank W Sellke

Abstract

Aprotinin is a naturally occurring serine protease inhibitor that is being used with increasing frequency in cardiac surgery and beyond to reduce blood loss and the need for perioperative blood transfusion. Through inhibition of serine proteases such as plasmin, aprotinin significantly reduces fibrinolysis, thereby aiding hemostasis during surgical procedures. In addition, aprotinin interacts with other factors in the coagulation and fibrinolytic cascade, creating a hemostatic balance, without increasing the risk of thrombosis. These proven benefits are supplemented by the anti-inflammatory properties of aprotinin, which may help curb some of the deleterious effects of cardiopulmonary bypass. This article will review the discovery of aprotinin, its mechanism of action, dosing and adverse effects, and highlight the major recent trials demonstrating its efficacy.

References

Apr 1, 1994·Journal of Cardiothoracic and Vascular Anesthesia·R J HuyzenW van Oeveren
May 1, 1994·Anesthesiology·J H LevyM Salmenperä
Oct 1, 1995·The Annals of Thoracic Surgery·P R FeindtE Gams
Dec 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·G E HillR A Robbins
Oct 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·M N D'AmbraR Maddi
Oct 6, 1999·The Annals of Thoracic Surgery·M J RayM F O'Brien
Aug 5, 2000·The Journal of Thoracic and Cardiovascular Surgery·G AsimakopoulosR C Landis
Aug 5, 2000·The Journal of Thoracic and Cardiovascular Surgery·M PoullisR C Landis
Aug 30, 2000·The Journal of Thoracic and Cardiovascular Surgery·K N MaquelinA Sturk
Nov 22, 2001·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·M A BedirhanO Taşçi
Nov 28, 2001·The Annals of Thoracic Surgery·R C LandisK M Taylor
Sep 26, 2002·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·L EnglbergerT P Carrel
Oct 31, 2002·The Journal of Thoracic and Cardiovascular Surgery·Diethard PrueferMichael Buerke
Jan 23, 2003·The Annals of Thoracic Surgery·Diethard PrueferMichael Buerke
Feb 20, 2003·Thrombosis Research·Marcus E CarrPhilip E Greilich
Feb 28, 2003·The Annals of Thoracic Surgery·Robert J FrumentoElliott Bennett-Guerrero
Feb 28, 2003·The Annals of Thoracic Surgery·David A Bull, Jennifer Maurer
May 22, 2003·Thrombosis Research·John F Bradfield, Arthur P Bode
Feb 5, 2004·The Annals of Thoracic Surgery·Peter K SmithJoseph Lipscomb
Feb 10, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Stephan R WilliamsRaymond Martineau
Jul 9, 2004·Orthopedics·Jerrold H Levy, Edward Sypniewski
Jul 9, 2004·Orthopedics·Jerrold H Levy
Jul 28, 2004·British Journal of Anaesthesia·A M Mahdy, N R Webster
Sep 9, 2004·The Journal of Thoracic and Cardiovascular Surgery·Artyom SedrakyanJohn A Elefteriades
Oct 1, 2004·The Journal of Thoracic and Cardiovascular Surgery·Tanveer A KhanFrank W Sellke
Dec 3, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Dominic C HarmonGeorge D Shorten
Dec 4, 2004·International Anesthesiology Clinics·Theodore A Alston
Feb 1, 2005·The Annals of Thoracic Surgery·Wolfram BeierleinGerhard Ziemer
Apr 27, 2005·Transfusion Medicine Reviews·Claudio S Cinà, Catherine M Clase
Apr 28, 2005·The Annals of Thoracic Surgery·Tanveer A KhanFrank W Sellke
May 4, 2005·The Journal of Bone and Joint Surgery. American Volume·Agnieszka KokoszkaMichael Neuwirth
Jun 24, 2005·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Effie L GillespieCraig I Coleman
Jun 25, 2005·The Annals of Thoracic Surgery·Enoch AkowuahGraham Cooper

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Citations

Apr 27, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Constantine P SpanosChristos Papaconstantinou
Jun 21, 2008·Advances in Chronic Kidney Disease·Mark Stafford-SmithMadhav Swaminathan
Nov 21, 2007·The Journal of Thoracic and Cardiovascular Surgery·Carl L BackerConstantine Mavroudis
May 29, 2007·The Annals of Thoracic Surgery·Alfredo J RodriguesWalter Villela de Andrade Vicente
May 1, 2007·The Journal of Thoracic and Cardiovascular Surgery·Elisabeth OttUNKNOWN Ischemia Research and Education Foundation
Apr 10, 2007·Journal of Cardiothoracic and Vascular Anesthesia·Steven E Hill
Jan 30, 2007·Hematology/oncology Clinics of North America·Jerrold H Levy
Sep 17, 2009·Journal of Cardiac Surgery·Basel RamlawiFrank W Sellke
Jul 22, 2008·The Annals of Thoracic Surgery·Stephen A OlenchockGeorge Tolis
Sep 25, 2007·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Barbara KostkaJoanna Sikora
Nov 4, 2006·Expert Review of Cardiovascular Therapy·Jennifer S LiPage A W Anderson
Oct 8, 2020·Molecular Biology Reports·Fatemeh Javaherforoosh ZadehHadi Rezaeeyan

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