The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 4 , Pages 729-731 , April 2008

The demise of aprotinin: Our share of the blame

  • Thoralf M. Sundt, MD

      Affiliations

    • Corresponding Author InformationAddress for reprints: Thoralf M. Sundt, MD, Division of Cardiovascular Surgery, Mayo Clinica and Foundation, 200 First St, SW, Rochester, MN 55905.

Received 3 February 2008 ,Accepted 4 February 2008.

References 

  1. Available at: http://www.trasylol.com/Trasylol_01_04_08-2.pdf. Accessed March 7, 2008.
  2. Mangano DT, Miao Y, Vuylsteke A, et al. Mortality associated with aprotinin during 5 years following coronary artery bypass graft surgery. JAMA. 2007;297:471–479
  3. Mangano DT, Tudor IC, Dietzel C. The risk associated with aprotinin in cardiac surgery. N Engl J Med. 2006;354:353–365
  4. Available at: http://www.ohri.ca/programs/clinical_epidemiology/thrombosis_group/studies/bart.asp. Accessed March 7, 2008.
  5. Available at: http://www.fda.gov/CDER/previous_news2007.htm. Accessed March 7, 2008.
  6. Sundt TM, Kouchoukos NT, Saffitz JE, et al. Renal dysfunction and intravascular coagulation with aprotinin and hypothermic circulatory arrest. Ann Thorac Surg. 1993;55:1418–1424
  7. Cosgrove DM, Heric B, Lytle BW, et al. Aprotinin therapy for reoperative myocardial revascularization: a placebo-controlled study. Ann Thorac Surg. 1992;54:1031–1038
  8. Westaby S, Katsumata T. Aprotinin and vein graft occlusion—the controversy continues. J Thorac Cardiovasc Surg. 1998;116:731–733
  9. Lemmer JH, Stanford W, Bonney SL, et al. Aprotinin for coronary bypass operations: efficacy, safety, and influence on early saphenous vein graft patency. A multicenter, randomized, double-blind, placebo-controlled study. J Thorac Cardiovasc Surg. 1994;107:543–553
  10. Taggart DP, Djapardy V, Naik M, Davies A. A randomized trial of aprotinin (Trasylol) on blood loss, blood product requirement, and myocardial injury in total arterial grafting. J Thorac Cardiovasc Surg. 2003;126:1087–1094
  11. Alderman EL, Levy JH, Rich JB, et al. Analyses of coronary graft patency after aprotinin use: results from the International Multicenter Aprotinin Graft Patency Experience (IMAGE) trial. J Thorac Cardiovasc Surg. 1998;116:716–730
  12. Rahman A, Ustunda B, Burma O, et al. Does aprotinin reduce lung reperfusion damage after cardiopulmonary bypass?. Eur J Cardiothorac Surg. 2000;18:583–588
  13. Frumento RJ, O'Malley CM, Bennett-Guerrero E. Stroke after cardiac surgery: a retrospective analysis of the effect of aprotinin dosing regimens. Ann Thorac Surg. 2003;75:479–484
  14. Harmon DC, Ghori KG, Eustace NP, et al. Aprotinin decreases the incidence of cognitive deficit following CABG and cardiopulmonary bypass: a pilot randomized controlled study. Can J Anaesth. 2004;51:1002–1009
  15. Smith PK, Datta SK, Muhlbaier LH, et al. Cost analysis of aprotinin for coronary artery bypass patients: analysis of the randomized trials. Ann Thorac Surg. 2004;77:635–643
  16. Gilovich T. How we know what isn't so: the fallibility of human reason in everyday life. New York: The Free Press; 1991;

PII: S0022-5223(08)00140-2

doi: 10.1016/j.jtcvs.2008.02.003

The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 4 , Pages 729-731 , April 2008

Article Tools