Aprotinin improves outcome of single-ventricle palliation

James S. Tweddell, Stuart Berger, Peter C. Frommelt, Andrew N Pelech, David A. Lewis, Raymond T. Fedderly, Michele A. Frommelt, Terrence S. McManus, Kathleen A. Mussatto, Maryanne W. Kessel, S. Bert Litwin

Research output: Contribution to journalArticle

31 Citations (Scopus)

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. Methds. 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.

Original languageEnglish (US)
Pages (from-to)1329-1336
Number of pages8
JournalAnnals of Thoracic Surgery
Volume62
Issue number5
DOIs
StatePublished - Nov 1996
Externally publishedYes

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Aprotinin
Fontan Procedure
Cardiopulmonary Bypass
Vascular Resistance
Oxygen
Mediastinitis
Serine Proteinase Inhibitors
Renal Insufficiency
Drainage
Thrombosis
Thorax
Retrospective Studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Tweddell, J. S., Berger, S., Frommelt, P. C., Pelech, A. N., Lewis, D. A., Fedderly, R. T., ... Litwin, S. B. (1996). Aprotinin improves outcome of single-ventricle palliation. Annals of Thoracic Surgery, 62(5), 1329-1336. https://doi.org/10.1016/0003-4975(96)00670-4

Aprotinin improves outcome of single-ventricle palliation. / Tweddell, James S.; Berger, Stuart; Frommelt, Peter C.; Pelech, Andrew N; Lewis, David A.; Fedderly, Raymond T.; Frommelt, Michele A.; McManus, Terrence S.; Mussatto, Kathleen A.; Kessel, Maryanne W.; Litwin, S. Bert.

In: Annals of Thoracic Surgery, Vol. 62, No. 5, 11.1996, p. 1329-1336.

Research output: Contribution to journalArticle

Tweddell, JS, Berger, S, Frommelt, PC, Pelech, AN, Lewis, DA, Fedderly, RT, Frommelt, MA, McManus, TS, Mussatto, KA, Kessel, MW & Litwin, SB 1996, 'Aprotinin improves outcome of single-ventricle palliation', Annals of Thoracic Surgery, vol. 62, no. 5, pp. 1329-1336. https://doi.org/10.1016/0003-4975(96)00670-4
Tweddell JS, Berger S, Frommelt PC, Pelech AN, Lewis DA, Fedderly RT et al. Aprotinin improves outcome of single-ventricle palliation. Annals of Thoracic Surgery. 1996 Nov;62(5):1329-1336. https://doi.org/10.1016/0003-4975(96)00670-4
Tweddell, James S. ; Berger, Stuart ; Frommelt, Peter C. ; Pelech, Andrew N ; Lewis, David A. ; Fedderly, Raymond T. ; Frommelt, Michele A. ; McManus, Terrence S. ; Mussatto, Kathleen A. ; Kessel, Maryanne W. ; Litwin, S. Bert. / Aprotinin improves outcome of single-ventricle palliation. In: Annals of Thoracic Surgery. 1996 ; Vol. 62, No. 5. pp. 1329-1336.
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AU - Frommelt, Michele A.

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