• Ehrenfried Schindler, Joachim Photiadis, Nicodème Sinzobahamvya, Albert Döres, Boulos Asfour, and Victor Hraska.
• Pediatric Anesthesiology, German Pediatric Heart Center, Sankt Augustin, Germany. e.schindler@asklepios.com
• Eur J Cardiothorac Surg. 2011 Apr 1;39(4):495-9.

ObjectiveThere has been concern about the usage of aprotinin, an antifibrinolytic drug that was often used in pediatric cardiac surgery until 2006. At our center, these concerns led to the replacement of aprotinin with tranexamic acid for antifibrinolytic treatment.MethodsIn this retrospective observational study, two groups of pediatric patients were studied during two different periods, receiving either aprotinin (n=70) or tranexamic acid (n=70) upon cardiac surgery. Data were collected from children with cyanotic heart defects, children who weighed less than 10 kg, and children who underwent re-operation.ResultsThere was no difference in terms of blood loss or amount of erythrocyte concentrates and fresh frozen plasma transfused. Only the intraoperative amount of platelet concentrate received by children in the tranexamic acid group was 29 ml (p=0.013) higher. There was no significant difference in the length of stay at the intensive care unit, in renal function values, or in the rate of rethoracotomy.ConclusionsThe results of this study suggest that tranexamic acid represents an adequate alternative to aprotinin in congenital cardiac surgery.Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

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