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The Medical Therapy of Hemorrhagic Complications Following Coronary Artery Bypass Grafting

The Medical Therapy of Hemorrhagic Complications Following Coronary Artery Bypass Grafting Abstract To the Editor.— We read with interest the excellent review article by Becker and Alpert1 in the October 1990 issue of the Archives. In our opinion, it might be useful that the readers of the Archives be provided with some data concerning aprotinin (Trasylol, Bayer AG, Leverkusen, Federal Republic of Germany), a drug available in most European countries and used for the treatment of hyperfibrinolytic hemorrhage and other indications, even though this drug is not registered in the United States.Aprotinin is a basic polypeptide, obtained from bovine lung. By forming reversible stoichiometric enzyme—inhibitor complexes, it acts as an inhibitor of human trypsin, plasmin, plasma, and tissue kallikrein. In 1987, Royston et al2 reported reduced blood loss and blood use in repeated coronary artery bypass grafting, due to the use of high doses of aprotinin (about 840 mg) during surgery. The decrease of postoperative bleeding was sufficient to ensure References 1. Becker C, Alpert S. The impact of medical therapy on hemorrhagic complication following coronary artery bypass grafting . Arch Intern Med. 1990;150:2016-2021.Crossref 2. Royston D, Bidstrup BP, Taylor KM, Sapsford RN. Effect of aprotinin on need for blood transfusions after repeat open heart surgery . Lancet. 1987;2:1289-1291.Crossref 3. Bidstrup BP, Royston D, Sapsford RN, Taylor KM. Reduction in blood loss and blood use after cardiopulmonary bypass with high dose aprotinin (Trasylol) . J Thorac Cardiovasc Surg. 1989;97:364-372. 4. Fraedrich G, Weber C, Bernard A, Hettwer A, Schlosser V. Reduction of blood transfusion requirement in open heart surgery by administration of high dose aprotinin: preliminary results . Thorac Cardiovasc Surg. 1989;37:89-91.Crossref 5. Dietrich W, Barankay A, Dilthey G, et al. Reduction in homologous blood requirement in cardiac surgery by intraoperative aprotinin application: clinical experience in 152 cardiac surgical patients . Thorac Cardiovasc Surg. 1989;37:92-98.Crossref 6. Van Oeveren W, Harder MP, Roozendaal KJ, Eijsman L, Wildevuur CRH. Aprotinin protects platelets against the initial effect of cardiopulmonary bypass . J Thorac Cardiovasc Surg. 1990;99:788-797. 7. Markland CG, Sturridge MF, Hulf GF, Woodal NM. Effect of aprotinin on blood loss in repeat open heart surgery . Lancet. 1988;1:711.Crossref 8. Dietrich W, Jochum M, Schramm W, Blümel G, Richter JA. Reduction in homologous blood requirement in cardiac surgery using high dose aprotinin . Anesthesiology. 1989;71:7. Abstract.Crossref 9. Van Oeveren W, Eijsman L, Roozendaal KJ, Wildevuur CRH. Platelet preservation by aprotinin during cardiopulmonary bypass . Lancet. 1988;1:644.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Medical Therapy of Hemorrhagic Complications Following Coronary Artery Bypass Grafting

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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400070198035
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— We read with interest the excellent review article by Becker and Alpert1 in the October 1990 issue of the Archives. In our opinion, it might be useful that the readers of the Archives be provided with some data concerning aprotinin (Trasylol, Bayer AG, Leverkusen, Federal Republic of Germany), a drug available in most European countries and used for the treatment of hyperfibrinolytic hemorrhage and other indications, even though this drug is not registered in the United States.Aprotinin is a basic polypeptide, obtained from bovine lung. By forming reversible stoichiometric enzyme—inhibitor complexes, it acts as an inhibitor of human trypsin, plasmin, plasma, and tissue kallikrein. In 1987, Royston et al2 reported reduced blood loss and blood use in repeated coronary artery bypass grafting, due to the use of high doses of aprotinin (about 840 mg) during surgery. The decrease of postoperative bleeding was sufficient to ensure References 1. Becker C, Alpert S. The impact of medical therapy on hemorrhagic complication following coronary artery bypass grafting . Arch Intern Med. 1990;150:2016-2021.Crossref 2. Royston D, Bidstrup BP, Taylor KM, Sapsford RN. Effect of aprotinin on need for blood transfusions after repeat open heart surgery . Lancet. 1987;2:1289-1291.Crossref 3. Bidstrup BP, Royston D, Sapsford RN, Taylor KM. Reduction in blood loss and blood use after cardiopulmonary bypass with high dose aprotinin (Trasylol) . J Thorac Cardiovasc Surg. 1989;97:364-372. 4. Fraedrich G, Weber C, Bernard A, Hettwer A, Schlosser V. Reduction of blood transfusion requirement in open heart surgery by administration of high dose aprotinin: preliminary results . Thorac Cardiovasc Surg. 1989;37:89-91.Crossref 5. Dietrich W, Barankay A, Dilthey G, et al. Reduction in homologous blood requirement in cardiac surgery by intraoperative aprotinin application: clinical experience in 152 cardiac surgical patients . Thorac Cardiovasc Surg. 1989;37:92-98.Crossref 6. Van Oeveren W, Harder MP, Roozendaal KJ, Eijsman L, Wildevuur CRH. Aprotinin protects platelets against the initial effect of cardiopulmonary bypass . J Thorac Cardiovasc Surg. 1990;99:788-797. 7. Markland CG, Sturridge MF, Hulf GF, Woodal NM. Effect of aprotinin on blood loss in repeat open heart surgery . Lancet. 1988;1:711.Crossref 8. Dietrich W, Jochum M, Schramm W, Blümel G, Richter JA. Reduction in homologous blood requirement in cardiac surgery using high dose aprotinin . Anesthesiology. 1989;71:7. Abstract.Crossref 9. Van Oeveren W, Eijsman L, Roozendaal KJ, Wildevuur CRH. Platelet preservation by aprotinin during cardiopulmonary bypass . Lancet. 1988;1:644.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1991

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