Analyses of coronary graft patency after aprotinin use: results from the International Multicenter Aprotinin Graft Patency Experience (IMAGE) trial.

@article{Alderman1998AnalysesOC,
  title={Analyses of coronary graft patency after aprotinin use: results from the International Multicenter Aprotinin Graft Patency Experience (IMAGE) trial.},
  author={E. Alderman and J. Levy and J. Rich and M. Nili and B. Vidne and H. Schaff and G. Uretzky and G. Pettersson and J. Thiis and C. Hantler and B. Chaitman and A. Nadel},
  journal={The Journal of thoracic and cardiovascular surgery},
  year={1998},
  volume={116 5},
  pages={
          716-30
        }
}
OBJECTIVE We examined the effects of aprotinin on graft patency, prevalence of myocardial infarction, and blood loss in patients undergoing primary coronary surgery with cardiopulmonary bypass. METHODS Patients from 13 international sites were randomized to receive intraoperative aprotinin (n = 436) or placebo (n = 434). Graft angiography was obtained a mean of 10.8 days after the operation. Electrocardiograms, cardiac enzymes, and blood loss and replacement were evaluated. RESULTS In 796… Expand
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TLDR
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TLDR
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References

SHOWING 1-10 OF 29 REFERENCES
Aprotinin for coronary bypass operations: efficacy, safety, and influence on early saphenous vein graft patency. A multicenter, randomized, double-blind, placebo-controlled study.
TLDR
In this study, aprotinin was effective in reducing bleeding and blood product transfusion rates, and its use was not associated with an increase in complications. Expand
Effect of aprotinin (Trasylol) on aorta-coronary bypass graft patency.
TLDR
In this study, high-dose aprotinin did not result in early saphenous vein graft occlusion after aorta-coronary bypass operations, further evidence that aProtinin reduces hemostatic derangement during cardiopulmonary bypass without creating a "prothrombotic" situation. Expand
Aprotinin does not decrease early graft patency after coronary artery bypass grafting despite reducing postoperative bleeding and use of donated blood.
TLDR
Aprotinin significantly reduced postoperative bleeding and transfusion requirement after coronary artery bypass grafting without influencing early graft patency. Expand
Aprotinin for primary coronary artery bypass grafting: a multicenter trial of three dose regimens.
TLDR
Low-dose and pump-prime-only aprotinin regimens provide reductions in bleeding and transfusion requirements that are similar to those of high-dose regimens. Expand
Reduction in blood loss and blood use after cardiopulmonary bypass with high dose aprotinin (Trasylol).
TLDR
The effect of high dose aprotinin (Trasylol) was evaluated in three groups of patients undergoing cardiopulmonary bypass: 80 patients having primary aorta-coronary bypass grafting, a prospective, placebo-controlled, double-blind study, and 80 patients receiving saline placebo from the beginning of the procedure until skin closure. Expand
A reappraisal of the factors affecting early patency of aortocoronary saphenous vein bypass grafts. Current experience with extensive revascularization employing sequential grafting techniques.
TLDR
Coronary artery diameter, patient's age and previous myocardial infarction were shown to be independent predictors of increased risk of anastomotic occlusion, and the use of side-to-side anastsomoses with sequential grafts seemed to counterbalance the unfavourable effect of small arterial size. Expand
A multicenter, double-blind, placebo-controlled trial of aprotinin for reducing blood loss and the requirement for donor-blood transfusion in patients undergoing repeat coronary artery bypass grafting.
TLDR
It is demonstrated that high- and low-dose aprotinin significantly reduces the requirement for donor-blood transfusion in repeat CABG patients without increasing the risk for perioperative MI. Expand
The factors influencing early patency of coronary artery bypass vein grafts: correlation of angiographic and ultrastructural findings.
TLDR
Electron microscopic analysis revealed severe spasm of venous smooth muscle in the blood-stored veins causing intraluminal smooth muscle cell cytoplasmic protrusions with resultant endothelial separation and desquamation and was not present in the solution-treated veins. Expand
Aprotinin therapy for reoperative myocardial revascularization: a placebo-controlled study.
TLDR
It is concluded that aprotinin is extremely effective in reducing bleeding and transfusion requirements and may increase the risk of graft thrombosis. Expand
Early and late patency of aortocoronary vein grafts.
TLDR
Patency was lower in symptomatic patients (54%) than in those who underwent consecutive reevaluation (80%) and there was a trend towards improved patency rates for graft anastomosed to the left anterior descending coronary artery and grafts without pre-existing pathological changes. Expand
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