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Yeungnam Univ J Med > Volume 28(2); 2011 > Article
Yeungnam University Journal of Medicine 2011;28(2):124-132.
DOI:    Published online December 31, 2011.
Effects of Combined Antiplatelets on Bleeding in Off-Pump Coronary-Artery Bypass Surgery.
Su Kyeong Lee, Tae Jin Kim, Song Yun Seok, Sun Ho Jung, Kyung Ho Yang, Kang Joo Choi, Young Bok Kim
1Department of Internal Medicine, Good Samaritan Hospital, Pohang, Korea.
2Department of Chest Surgery, Dongkang Medical Center, Ulsan, Korea.
BACKGROUND: Antiplatelet agent administration is critical in managing coronary-artery disease, but there is a concern regarding operation-related bleeding and an increase in blood transfusion in such, especially when delivering combined antiplatelet agents. This study was conducted to evaluate the effect of the administration of antiplatelet agents on off-pump coronary-artery bypass surgery (OPCAB). METHODS: From March 2003 to December 2009, 49 patients who had undergone OPCAB were collected retrospectively. The patients were divided into three groups according to the administration of antiplatelet agents before the OPCAB operation: 21 patients were given an aspirin agent (group 1), 19 patients were given combined agents (aspirin+clopidogrel) (group 2), and nine patients were not given any antiplatelet agent (group 3). The three groups' perioperative hematologic and coagulation profiles, including their platelet counts, hemoglobin levels, hematocrit, prothrombin times, and aPTTs (activated partial thromboplastin times), and their postoperative bleeding, related complications, transfusion requirements, and operation times, were compared. RESULTS: The operation time in group 2 was 4.3 hours, longer than those in the two other groups, and urgent operation was significantly most frequent in group 2 (63%). The amount of blood loss and the number of patients who received blood transfusion were not different in the three groups. The perioperative hemoglobin level, hematocrit, platelet count, prothrombin time, and aPTT were also not significantly different among the three groups. CONCLUSION: The continuous administration of antiplatelet agents to the patients in this study did not increase their postoperative bleeding or operation-related complications. Therefore, OPCAB may well be considered even if combined antiplatelet agents are being administered.
Key Words: Antiplatelet agents, Off-pump coronary-artery bypass, Hemorrhage
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