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Effects of preoperative aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in patients undergoing off-pump coronary artery bypass graft surgery

Authors
 Jae Kwang Shim  ;  Yong Seon Choi  ;  Young Lan Kwak  ;  Kyung Jong Yoo  ;  Sou Ouk Bang  ;  Young Jun Oh 
Citation
 JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, Vol.134(1) : 59-64, 2007 
Journal Title
 JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 
ISSN
 0022-5223 
Issue Date
2007
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Heart Valve Diseases/surgery* ; Heart Valve Prosthesis* ; Heart Valve Prosthesis Implantation/instrumentation* ; Heart Valve Prosthesis Implantation/mortality ; Humans ; Male ; Middle Aged ; Mitral Valve/surgery* ; Prospective Studies ; Treatment Outcome
Abstract
OBJECTIVE: Preoperative exposure to clopidogrel and aspirin significantly increases postoperative bleeding in patients undergoing on-pump coronary artery bypass graft surgery. Off-pump coronary bypass grafting has been proposed as an alternative technique to attenuate postoperative bleeding associated with clopidogrel. This study aimed to determine the effects of aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in off-pump coronary artery bypass grafting. METHODS: One hundred six patients scheduled for off-pump coronary artery bypass grafting were divided into three groups: aspirin and clopidogrel discontinued more than 6 days before surgery (group 1, n = 35), aspirin and clopidogrel continued until 3 to 5 days before surgery (group 2, n = 51), and both medications continued within 2 days of surgery (group 3, n = 20). Thromboelastographic tracings were analyzed before induction of anesthesia. Routine coagulation profiles were measured before and after surgery. A cell salvage device was used during surgery and salvaged blood was reinfused. Chest tube drainage and blood transfusion requirement were recorded postoperatively. RESULTS: Patient characteristics, operative data, and thromboelastographic tracings were similar among the groups. There were significant decreases in hematocrit level and platelet count and prolongation in prothrombin time postoperatively in all groups without any intergroup differences. The amounts of perioperative blood loss and blood transfusion required were all similar among the groups. CONCLUSION: Preoperative clopidogrel and aspirin exposure even within 2 days of surgery does not increase perioperative blood loss and blood transfusion requirements in patients undergoing elective off-pump coronary artery bypass grafting.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022522307005454
DOI
10.1016/j.jtcvs.2007.03.013
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Bang, Sou Ouk(방서욱)
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96699
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