1Associate Professor, Cardiac Anesthesia, U N Mehta Institute of Cardiology & Research Centre, B. J. Medical College, Ahmedabad - 16
2Associate Professor, Cardio Vascular Thoracic Surgery, U N Mehta Institute of Cardiology & Research Centre, B. J. Medical College, Ahmedabad - 16
3Chief Perfusionist, U N Mehta Institute of Cardiology & Research Centre, B. J. Medical College, Ahmedabad - 16
Antifibrinolytic agents are used to reduce post-operative blood loss during cardiac surgeries. Paucity of literature on tranexamic acid in patients undergoing tetralogy of fallot repair encouraged us for this study at a tertiary cardiac care center. Administration of antifibrinolytic agent tranexamic acid decreases bleeding and transfusions during postoperative period.
Sixty pediatric patients undergoing surgical repair for tetralogy of fallot were divided into two groups. The control (Group-A) did not receive the drug while the study group (Group-B) received IV tranexamic acid at pre-incision, during priming and heparin reversal at 10 mg/kg. Blood loss, need for supplementation of blood and blood products, coagulation parameters and re-exploration rate were compared between the groups.
Both groups had comparable demographic parameters (age, weight, and body surface area and tetralogy of fallot characteristics). Tranexamic acid treated patients experienced lesser blood loss (p<0.0003), need for PCV (p<0.0001) or Fresh Frozen Plasma (FFP; p<0.0001). Improved coagulation parameters [increased Fibrinogen content (p<0.01) and platelets (p<0.01); decreased activated clotting time (p<0.01) and fibrin degradation product (p<0.01) were also seen in drug treated patients.
Tranexamic acid was effective in reducing post-operative blood loss with improved coagulation parameters. We therefore advocate its routine use for tetralogy of fallot repair surgeries in pediatric patients.
Tetralogy of Fallot, Congenital Heart Diseases, Cardio Pulmonary Bypass, Ventricular Septal Defect
