Effects of tranexamic acid on the perioperative bleeding and blood coagulation in robotic assisted mitral valve surgery

Feng Long; Chen Ting-ting; Zhou Qi; Wang Gang

doi:10.13498/j.cnki.chin.j.ecc.2014.03.13

Abstract：Objective To evaluate the effects of tranexamic acid on the perioperative bleeding and blood coagulation in robotic assisted mitral valve surgery. Methods Forty patients scheduled to receive robotic assisted mitral valve surgery were randomly as-signed into tranexamic acid group ( TG) and control group ( CG) . In TG group, a loading dose of tranexamic acid 15 mg/kg was intra-venously infused over 10 min after induction of anesthesia, and followed by continuous infusion of 10 mg/( kg·h) until the end of car-diopulmonary bypass ( CPB) , whereas in CG group tranexamic acid was not applied. The patient’ s characteristics, intraoperative blood loss and fluid infusion, length of CPB and aortic cross-clamp time, postoperative 24 h chest-tube drainages and the changes of PT, APTT, Cr and BUN were recorded. Results Comparisons between the two groups in the patient characteristics, fluid infusion, urines, amount of bleeding, length of CPB and aortic cross-clamp time, there were not statistically significant differences ( P>0.05) . The a-mount of bleeding and post-operation 24 h chest-tube drainages in TG group were significant less than those in CG group ( P<0.05) , which were (215.4±42.2) ml vs (285.6±51.6) ml and (226±127) ml vs (361±237) ml, respectively. PT and APTT in TG group were significantly shorter than those in CG group ( P<0.05), which were (15.23±1.58)s vs (16.98±2.26)s and (40.98±7.00) s vs (54.50±26.53) s, respectively. The increase of plasma Cr and BUN at post-operation 24 h in CG group was more significant compared with that in TG group. Conclusion Tranexamic acid can significantly reduce the amount of bleeding and postoperative 24 h chest-tube drainages in robotic assisted mitral valve surgery, and has not obvious adverse effect on the kidney function.