Re-graft patency and clinical efficacy of aprotinin in elective bypass surgery.

To investigate possible influence of aprotinin on graft patency, a randomized, double-blind group comparative study was carried out in male patients selected for primary bypass surgery. One hundred and ten patients received either placebo treatment or aprotinin according to the Hammersmith Hospital regimen(n = 55 per group). Graft patency was evaluated by angiography in 44 aprotinin and 35 placebo patients between the 18th and 35th day postoperatively. There was no difference in overall graft occlusion. Among the aprotinin patients, 73% (32/44) hsd grafts patent compared with 71% (25/35) of the placebo group. Graft occlusion was not accompanied by signs of myocardial infarction in any case. Blood loss within 6 h postoperatively was reduced by 58.5% in the aprotinin group (P < 0.001). of these patients 51% (26/51) did not need donor blood compared with 21% (10/47) of the placebo patients (P = 0.003). Mean transfusion requirements per patient were 1.1 and 2.7 units in the aprotinin and placebo groups, respectively.