Effect of recombinant aprotinin on postoperative blood loss and coronary vascular function in a canine model of cardiopulmonary bypass

Veres, Gábor; Radovits, Tamás; Schultz, Holger; Li, Lin; Hütter, Joachim; Weigang, Ernst; Szabo, Gábor; Szabó, Gábor

doi:10.1016/j.ejcts.2007.02.039

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…In a canine model with cardiopulmonary bypass, Veres et al detected less postoperative bleeding in aprotinin-treated animals. Endothelium-dependent relaxation of the coronary arteries in response to acetylcholine and bradykinin was unaffected in the aprotinin treatment group of their study [40]. These data support our findings, that aprotinin does not impair the vascular function in patients undergoing CABG surgery.…”

Section: Discussionsupporting

confidence: 87%

Aprotinin does not Impair Vascular Function in Patients Undergoing Coronary Artery Bypass Graft Surgery

et al. 2023

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Bleeding is a major complication in coronary artery bypass graft surgery. Antifibrinolytic agents like serine protease inhibitor aprotinin can decrease postoperative bleeding and complications of cardiac surgery. However, the effects of aprotinin on vascular function are not completely elucidated. We compared the ex vivo vascular function of left internal mammary arteries from patients undergoing coronary artery bypass graft surgery with and without intraoperative application of aprotinin using a Mulvany Myograph. Human internal mammary arteries were treated with aprotinin ex vivo and tested for changes in vascular function. We analyzed the impact of aprotinin on vascular function in rat aortic rings. Finally, impact of aprotinin on expression and activity of endothelial nitric oxide synthase was tested in human endothelial cells. Intraoperative application of aprotinin did not impair ex vivo vascular function of internal mammary arteries of patients undergoing coronary artery bypass graft surgery. Endothelium-dependent and -independent relaxations were not different in patients with or without aprotinin after nitric oxide synthase blockade. A maximum vasorelaxation of 94.5%±11.4vs. 96.1%±5.5% indicated a similar vascular smooth muscle function in both patient groups (n=13 each). Long-term application of aprotinin under physiological condition preserved vascular function of the rat aorta. In vitro application of increasing concentrations of aprotinin on human endothelial cells resulted in a similar expression and activity of endothelial nitric oxide synthase. In conclusion, intraoperative and ex vivo application of aprotinin does not impair the endothelial function in human internal mammary arteries and experimental models.

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Section: Discussionsupporting

confidence: 87%

Aprotinin does not Impair Vascular Function in Patients Undergoing Coronary Artery Bypass Graft Surgery

et al. 2023

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“…El Kebir et al [ 47 , 48 ] have shown, in two studies, that the inhalation of NO prior to CPB reduces neutrophils and IL-8. Aprotinin, a fibrinolysis retardant studied by Liu et al [ 49 ] and Veres et al [ 50 ] , also reduced the levels of IL-8, in addition to increase platelet number, although has not changed the endothelium-dependent arteriolar relaxation after administration of acetylcholine or bradykinin, as the authors expected.…”

Section: Resultsmentioning

confidence: 59%

Managing the inflammatory response after cardiopulmonary bypass: review of the studies in animal models

Liguori¹,

Kanas²,

Moreira³

2014

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveTo review studies performed in animal models that evaluated therapeutic interventions to inflammatory response and microcirculatory changes after cardiopulmonary bypass.MethodsIt was used the search strategy ("Cardiopulmonary Bypass" (MeSH)) and ("Microcirculation" (MeSH) or "Inflammation" (MeSH) or "Inflammation Mediators" (MeSH)). Repeated results, human studies, non-English language articles, reviews and studies without control were excluded.ResultsBlood filters, system miniaturization, specific primers regional perfusion, adequate flow and temperature and pharmacological therapies with anticoagulants, vasoactive drugs and anti-inflammatories reduced changes in microcirculation and inflammatory response.ConclusionDemonstrated efficacy in animal models establishes a perspective for evaluating these interventions in clinical practice.

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“…Vascular and in particular endothelial function is an important determinant of functional recovery after cardiac surgery with CPB and early thrombus formation. In a recent report, 21 we showed for the first time in a clinically relevant mammalian model of CPB that aprotinin has no significant effect on vascular function in epicardial coronary arteries. Previous investigations on the endothelial effects of aprotinin in other models have resulted in conflicting results.…”

Section: Discussionmentioning

confidence: 82%

Effects of novel synthetic serine protease inhibitors on postoperative blood loss, coagulation parameters, and vascular relaxation after cardiac surgery

Szabó

Veres

Radovits

et al. 2010

The Journal of Thoracic and Cardiovascular Surgery

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Effect of recombinant aprotinin on postoperative blood loss and coronary vascular function in a canine model of cardiopulmonary bypass

Abstract: The effectiveness of recombinant aprotinin on blood loss was equivalent to bovine-derived aprotinin. Neither types of aprotinin impaired endothelium-dependent relaxation in a canine model of cardiopulmonary bypass.

Cited by 6 publications

References 25 publications

Aprotinin does not Impair Vascular Function in Patients Undergoing Coronary Artery Bypass Graft Surgery

Aprotinin does not Impair Vascular Function in Patients Undergoing Coronary Artery Bypass Graft Surgery

Managing the inflammatory response after cardiopulmonary bypass: review of the studies in animal models

Effects of novel synthetic serine protease inhibitors on postoperative blood loss, coagulation parameters, and vascular relaxation after cardiac surgery

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