Boston - American Association for Thoracic Surgery

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTSF3. The Novel Synthetic Serine-Protease Inhibitor CU2010 Dose-Dependently Reduces Postoperative Blood Loss and ImprovesPostischemic Recovery After Cardiac SurgeryGábor Szabó, Tamás Radovits, Gábor Veres, Matthias KarckDepartment of Cardiac Surgery, University of Heidelberg, Heidelberg, GermanyInvited Discussant: John A. ElefteriadesOBJECTIVE: Serine-protease inhibitors such as aprotinin reduce perioperativeblood loss and may improve post pump cardiac performance due to their antiinflammatoryproperties. After the “aprotinin era”, we investigated the efficacy ofthe novel synthetic serine-protease inhibitor CU2010 with improved coagulatoryand anti-inflammatory profile on blood loss and reperfusion injuryin a caninemodel.METHODS: 36 dogs were divided into six groups: control, aprotinin (Hammersmithscheme), and CU2010 (0.5; 0.83; 1.25 and 1.66 mg/kg). All animals underwent90-minute cardiopulmonary bypass with 60 minutes of hypothermic cardioplegicarrest. Endpoints were blood loss during the first two hours after application ofprotamin, as well as recovery of myocardial contractility (slope of the end-systolicpressure volume relationship, Ees), coronary blood flow and vascular reactivity.RESULTS: CU2010 dose-dependently reduced blood loss which was comparble toaprotinin at lower doses and even further improved at higher doses (Figure 1, *p