Korean J Thorac Cardiovasc Surg.  1997 May;30(5):501-505.

Safety of Aprotinin Under Hypothermic Circulatory Arrest

• Chang BC
• Kim JT
• Kwak YL
• Kim SH
• Yoo KJ
• Lee CH
• Hong YW

Abstract

It was reported that use of aprotinin in elderly patients undergoing hypothermic circulatory arrest was associated with an increased risk of renal dysfunction, and myocardial infarction as a result of intravascular coagulation. We reviewed 20 patients who received high-dose aprotinin under deep hypothermic circulatory arrest with(NP group, n=11) or without selective cerebral perfusion(SP group, n=9). The activated clotting time was exceeded 750 seconds in all but 1 patient. After opening aortic arch, retrograde low flow perfusion was maintained through femoral artery to prevent air embolization to the visceral arteries. Four patients among 20 died during hospitalization due to bleeding, coronary artery dissection, pulmonary hemorrhage and multiple cerebral infarction. Postoperatively, cerebrovascular accidents occurred in two patients; one with preoperative carotid artery dissection and the other with unknown multiple cerebral infarction. In conclusion, use of aprotinin in young patients undergoing hypothermic circulatory arrest did not increase the risk of renal dysfunction or intravascular coagulation if ACT during circulatory arrest is maintained to exceed 750 seconds with low-flow perfusion.

Keyword

Total circulatory arrest, induced; Aprotinin; Renal failure, acute; Activated clotting time

MeSH Terms

Acute Kidney Injury
Aged
Aorta, Thoracic
Aprotinin*
Arteries
Carotid Arteries
Cerebral Infarction
Circulatory Arrest, Deep Hypothermia Induced
Coronary Vessels
Femoral Artery
Hemorrhage
Hospitalization
Humans
Myocardial Infarction
Perfusion
Stroke
Aprotinin