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Does use of aprotinin in coronary artery bypass graft surgery affect graft patency?

^a Department of Cardiothoracic Surgery, North Staffordshire Royal Infirmary, Stoke, UK
^b Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK

^* Corresponding author. Tel.: +44-7801548122
joeldunning{at}doctors.org.uk

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether use of aprotinin in coronary artery bypass graft surgery adversely affects graft patency. Altogether 45 papers were identified using the below mentioned search, of which 10 presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that aprotinin clearly reduces blood loss, requirement for blood transfusion, and the risk of reoperation for bleeding, but does increase the risk of saphenous vein graft occlusion.

Key Words: Evidence-based medicine; Thoracic surgery; Aprotinin; Graft patency; Meta-analysis

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