Tranexamic Acid Reduces Bleeding during Off-Pump Coronary Artery Bypass Grafting in a Patient on Clopidogrel

(Department of Cardiovascular Surgery, Fukuoka University School of Medicine, Fukuoka, Japan)

Hidehiko Iwahashi Tadashi Tashiro Noritsugu Morishige
Yoshio Hayashida Nobuhisa Ito Kazuma Takeuchi
Masaru Nishimi Go Kuwahara Yuta Sukehiro
A 72-year-old man was admitted to a local hospital with symptoms of unstable angina pectoris. He was given Clopidogrel for acute coronary syndrome. Coronary angiography showed left main trunk and three-vessel disease. He was then admitted to our hospital due to a sudden onset of unstable angina following shock during the PCI procedure. We performed emergency off-pump coronary artery bypass grafting(OPCAB). He received 10mg/kg/h tranexamic acid during the operation. He also received 2,000U ascorbic acid at the start of surgery and 2,000U after undergoing anastomoses of the coronary artery. Postoperatively, only some minor bleeding was observed. Tranexamic acid and Ascorbic acid reduce bleeding, and transfusion requirements of packed red blood cells, platelets, and the total blood units in patients on Clopidogrel who undergo emergency OPCAB.
  Jpn. J. Cardiovasc. Surg. 38:389-393(2009)

Keywords:DES, OPCAB, Clopidogrel, Tranexamic acid, Ascorbic acid