Effects of tranexamic acid on coagulation indexes of patients undergoing heart valve replacement surgery under cardiopulmonary bypass

Abstract

This study aims to explore the effects of tranexamic acid on the coagulation indexes of patients undergoing heart valve replacement surgery under the condition of cardiopulmonary bypass (CPB). One hundred patients who conformed to the inclusive criteria were selected and divided into a tranexamic acid group and a non-tranexamic acid group. They all underwent heart valve replacement surgery under CPB. Patients in the tranexamic acid group were intravenously injected with 1 g of tranexamic acid (100 mL) at the time point after anesthesia induction and before skin incision and at the time point after the neutralization of heparin. Patients in the non-tranexamic acid group were given 100 mL of normal saline at corresponding time points, respectively. Then the coagulation indexes of the two groups were analyzed. The activated blood clotting time (ACT) of the two groups was within normal scope before CPB, while four coagulation indexes including prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), and fibrinogen (FIB) had significant increases after surgery; the PT and INR of the tranexamic acid group had a remarkable decline after surgery. All the findings suggest that the application of tranexamic acid in heart valve replacement surgery under CPB can effectively reduce intraoperative and postoperative blood loss.

Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review

“…The operative time was also significantly decreased in the treatment group. Intraoperative bleeding increases the operative time because it creates the need for multiple pauses during surgery for suctioning and packing, 28,29 which could explain that result. The previous meta-analysis demonstrated that operative time tended to decrease with the use of tranexamic acid compared to controls but without statistical significance, which was different from our result.…”

Tranexamic acid in total shoulder arthroplasty under regional anesthesia: a randomized, single blinded, controlled trial

“…Few studies evaluate the impact of TXA in coagulation parameters. 24 Our results demonstrate a decrease in aPTT when TXA is administered. The latter helps explain the effect of TXA in bleeding control and presents biological plausibility, since TXA is an antifibrinolytic drug.…”

Update on Applications and Limitations of Perioperative Tranexamic Acid

“…[43][44][45] Efficacy has been demonstrated in patients undergoing closed-and open-chamber procedures. 5,46 Similarly, aortic procedures involving deep hypothermic circulatory arrest (DHCA), where the effects of hypothermia can further promote fibrinolysis, benefit from TXA. 47,48 However, several questions and concerns remain despite antifibrinolytics becoming a standard of care in this setting.…”