Background: Post-operative bleeding from microvascular is one of the most common complications in open heart surgery. Several studies have shown that using intravenous antifibrinolytic drugs such as Tranexamic acid can help reduce post-operative blood loss. Topical Tranexamic acid applied to the surgical site can also be used to reduce amount of blood loss after many kinds of surgery. This study wanted to prove that topical Tranexamic acid is useful in open heart surgery as well.
Objective: To investigate the effect of topical application of Tranexamic acid in bleeding after open heart surgery and its adverse effects
Methods: In this randomized, double-blind study, XX patients scheduled for elective open heart surgery were included and randomly assigned to group I (Tranexamic acid group) or group II (placebo group). Tranexamic acid in saline solution or placebo was applied into pericardial cavity before closing of the sternum. Post-operative blood loss was recorded from mediastenal drainage hourly.
Results: Mean Mediastenal drainage in the first 24 hr after surgery in group II was significantly higher (xx +/- xx) than group II (xx +/- xx)(P-value=xx). Rate of re-sternotomy due to post-operative bleeding was also higher in group II. There was no adverse event of thromboembolism or cardiac tamponade.
Conclusions: Topical application of tranexamic acid in patients undergoing open heart surgery
can reduce the amount of post-operative blood loss without significant adverse effect.
Keywords: Randomized control trial, Tranexamic acid, Open heart surgery, Post-operative Bleeding