Faculty Collaboration Database

Aprotinin improves outcome of single-ventricle palliation. Ann Thorac Surg 1996 Nov;62(5):1329-35; discussion 1335-6

Date

11/01/1996

Pubmed ID

8893564

DOI

10.1016/0003-4975(96)00670-4

Scopus ID

2-s2.0-0030296431 (requires institutional sign-in at Scopus site)   35 Citations

Abstract

BACKGROUND: Elevation of pulmonary vascular resistance as a consequence of cardiopulmonary bypass may lead to failure of single-ventricle palliation. We reviewed our experience with aprotinin, a nonspecific serine protease inhibitor, to determine whether it could ameliorate the inflammatory effects of cardiopulmonary bypass and improve outcome of single-ventricle palliation.

METHODS: Forty-six consecutive patients undergoing single-ventricle palliation using cardiopulmonary bypass were reviewed retrospectively. Aprotinin was used in 8 of 30 bidirectional cavopulmonary shunt and 10 of 16 Fontan procedures.

RESULTS: Aprotinin use was associated with a decrease in the early postoperative transpulmonary gradient among patients undergoing Fontan and bidirectional cavopulmonary shunt procedures. The bidirectional cavopulmonary shunt aprotinin group had a higher oxygen saturation and a decrease in quantity and duration of thoracic drainage. Among patients receiving aprotinin there were no episodes of mediastinitis, thrombus formation, or renal failure.

CONCLUSIONS: Aprotinin use in single-ventricle palliation was associated with decreased transpulmonary gradient and increased oxygen saturation consistent with decreased pulmonary vascular resistance. This retrospective study suggests that aprotinin has a favorable impact on the early postoperative course of single-ventricle palliation.

Author List

Tweddell JS, Berger S, Frommelt PC, Pelech AN, Lewis DA, Fedderly RT, Frommelt MA, McManus TS, Mussatto KA, Kessel MW, Litwin SB

Authors

Raymond T. Fedderly MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michele Ann Frommelt MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Peter C. Frommelt MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Kathleen Mussatto Ph.D. Associate Professor in the School of Nursing department at Milwaukee School of Engineering

MESH terms used to index this publication - Major topics in bold

Aprotinin
Child
Child, Preschool
Combined Modality Therapy
Congenital Abnormalities
Heart Bypass, Right
Heart Ventricles
Humans
Infant
Palliative Care
Postoperative Care
Pulmonary Circulation
Retrospective Studies
Serine Proteinase Inhibitors
Treatment Outcome
Vascular Resistance