Tranexamic acid in aortic valve replacement

Objective: To assess the relative efficacy of tranexamic acid compared with a control group to decrease bleeding and transfusion requirements in a uniform population undergoing aortic valve replacement. Design: Prospective, randomized, double-blind study. Settings: University hospital, Participants: Adult cardiac surgery patients (n = 300), Interventions: Patients were randomized into 2 groups to receive either a total of 5 g of tranexamic acid or a saline solution. Bleeding in the postoperative period, transfusions of bank blood products, coagulation profile, intensive care unit stay, and hospital length of stay were recorded. Measurements and Main Results: Postoperative bleeding in patients treated with tranexamic acid was significantly lower compared with the control group (p < 0.0001). Packed red blood cells and fresh frozen plasma usage were reduced in the tranexamic acid group compared with the control group (p = 0.0095 and p < 0.0001). Only 24.5% of tranexamic acid patients received blood products versus 45% of control patients (p < 0.01). There was no significant difference in hematologic and coagulation profiles after the operation between the groups. Conclusions: Tranexamic acid reduces postoperative blood loss and transfusion requirements in elective aortic valve replacement. Copyright (C) 2001 by W.B. Saunders Company.