Background
Concerns about safety of aprotinin in adult patients arose in 2006, which had a dramatic impact on the use of aprotinin. Due to these safety concerns, we replaced aprotinin with tranexamic acid in our congenital cardiac surgical program.
Methods
In this retrospective study, we compared two different groups of children undergoing cardiac surgery before and after replacing aprotinin with tranexamic acid. The first group (n = 70) included children receiving only aprotinin before our change. The second group (n = 70) included children receiving only tranexamic acid after the change. Data from all children with cyanotic heart failure, weighing under 10 kg or children undergoing repeat cardiac surgery, were collected.
Results
Perioperatively and postoperatively, similar amounts of red cells and FFP were transfused. However, perioperatively, children in the tranexamic acid group received 31 ml (p = 0.013) more platelets. No statistical differences were found in postoperative blood loss, creatinine values or in the incidence of rethoracotomies and early deaths.
Conclusion
The results of this study suggest that in pediatric cardiac surgery tranexamic acid is an adequate alternative for aprotinin.