• The heart surgery forum · Aug 2010

    Tranexamic Acid in cardiac surgery and postoperative seizures: a case report series.

    • David Bell, Silvana Marasco, Aubrey Almeida, and Michael Rowland.
    • Department of Surgery, Monash University, Melbourne, Australia.
    • Heart Surg Forum. 2010 Aug 1;13(4):E257-9.

    AbstractWith the recent withdrawal of the antifibrinolytic aprotinin from the market, tranexamic acid (TxA) has become more widely used. This change has led to increasing concern about the side-effect profile of TxA, particularly the incidence of postoperative seizures. In this case series, we describe 7 patients over an 18-month period who had open-chamber cardiac surgery and developed seizures in the postoperative period. This incidence is increased compared with that of a cohort of patients in the previous 36 months who did not receive TxA (0.66% versus 0%; P < .05). The exact mechanism of TxA-induced seizures is thought to be via inhibition of gamma-aminobutyric acid receptors in neurons. Data from the neurosurgical literature show a well-established link between this antifibrinolytic and seizures. There is now increasing awareness of this association in cardiac surgery, particularly when high TxA doses are used.

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