Efficacité différentielle de l'aprotinine et de l'acide tranexamique selon le type de chirurgie cardiaque

Our preliminary results indicated that tolerance to aprotinin was as good as for tranexamic acid. Concerning its effectiveness, results differed according to the type of surgery. The benefit/risk ratio of aprotinin in our study was positive for coronary artery bypass surgery, but the use of tranexamic acid in valve surgery was as efficient and much less expensive than aprotinin. Our data suggest that even if the marketing application authorization of aprotinin was suspended, this drug should have clinical benefit for coronary artery bypass surgery. Therefore, our study shows that it is difficult to reach an unequivocal result about the use of aprotinin. Further investigations of aprotinin must be conducted in different types of cardiac surgery and among different patients populations like in pediatrics in which its efficiency and safety profiles are not clear.