Administration of high-dose aprotinin during nonprimary cardiovascular surgery: Case reports and review of the literature

The perioperative management of two patients undergoing complex "redo" cardiac surgical procedures are presented. The management of both patients included the prophylactic administration of aprotinin via a "compassionate use" protocol. Aprotinin, a serine protease inhibitor, has been shown to limit the exposure to blood and blood products in patients undergoing high-risk cardiac surgical procedures. In late December 1993, the Food and Drug Administration approved aprotinin for administration to cardiac surgical patients considered at high risk for post-cardiopulmonary bypass coagulopathies. Indications for the administration of aprotinin, as well as a brief review of the literature relating to the perioperative administration of aprotinin, are included.