Journal of Thrombosis and Thrombolysis

, Volume 32, Issue 3, pp 303–310

Local and systemic application of tranexamic acid in heart valve surgery: a prospective, randomized, double blind LOST study

  • Jan Spegar
  • Tomas Vanek
  • Jana Snircova
  • Richard Fajt
  • Zbynek Straka
  • Petra Pazderkova
  • Marek Maly
Article

DOI: 10.1007/s11239-011-0608-3

Cite this article as:
Spegar, J., Vanek, T., Snircova, J. et al. J Thromb Thrombolysis (2011) 32: 303. doi:10.1007/s11239-011-0608-3

Abstract

The study was performed to examine a possible augmentation of systemic administration of tranexamic acid by the additional topical application during heart valve surgery in the post-aprotinin era. One-hundred patients were enrolled in the study and all the patients were given tranexamic acid intravenously. The participants were randomized into two groups (A, n = 49; B, n = 51), and before commencing the sternal suturing, the study solution (group A: 250 ml of normal saline + tranexamic acid 2.5 g, placebo group B: 250 ml of normal saline) was poured into the pericardial cavity. The cumulative blood loss (geometric means [95% confidence intervals]) 4 h after the surgery was 86.1 [56.1, 132.2] ml in group A, and 135.4 [94.3, 194.4] in group B, test for equality of geometric means P = 0.107, test for equality of variances P = 0.059. Eight hours after the surgery, the blood loss was 199.4 [153.4, 259.2] ml in group A, 261.7 [205.1, 334.0] ml in group B, P = 0.130 and P = 0.050, respectively. Twenty-four hours postoperatively the blood loss was 504.2 [436.0, 583.0] ml in group A, 569.7 [476.0, 681.7] ml in group B, P = 0.293 and P = 0.014, respectively. The proportion of patients transfused postoperatively by fresh frozen plasma differed significantly between the two study groups (group A: n = 21, group B: n = 36, P = 0.008). Our hypothesis is supported by a significant difference in the inter-group variance of blood loss and the proportion of patients requiring fresh frozen plasma; however evident differences in mean postoperative blood loss were not statistically significant.

Keywords

Heart valve surgeryFibrinolysisFibrinolytic inhibitorsTranexamic acid

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jan Spegar
    • 1
  • Tomas Vanek
    • 1
  • Jana Snircova
    • 1
  • Richard Fajt
    • 1
  • Zbynek Straka
    • 1
  • Petra Pazderkova
    • 1
  • Marek Maly
    • 2
  1. 1.Department of Cardiac Surgery, Third Faculty of MedicineCharles University Prague and University Hospital Kralovske VinohradyPragueCzech Republic
  2. 2.Department of Scientific Information and Biostatistics, Centre of Public Health Protection and PromotionNational Institute of Public HealthPragueCzech Republic