Preoperative Aspirin Does Not Increase Transfusion or Re-operation in Isolated Valve Surgery

• Published in: Journal of cardiothoracic and vascular anesthesia 2017
• Main Authors: Goldhammer, Jordan E., MD, Herman, Corey R., MD, Berguson, Mark W., MD, Torjman, Marc C., PhD, Epstein, Richard H., MD, Sun, Jian-Zhong, MD
• Format: Article
• Language: English
• Subjects: Anesthesia & Perioperative Care; Critical Care
• ISSN: 1053-0770
• DOI: 10.1053/j.jvca.2017.05.011

Objective Preoperative aspirin has been studied in patients undergoing isolated coronary artery bypass graft surgery (CABG). However, there is a paucity of clinical data available evaluating perioperative aspirin in other cardiac surgical procedures. This study was designed to investigate the effects of aspirin on bleeding and transfusion in patients undergoing non-emergent, isolated, heart valve repair or replacement. Design Retrospective, cohort study. Setting Academic medical center. Participants 694 consecutive patients having non-emergent, isolated, valve repair or replacement surgery at an academic medical center were identified. Interventions Of the 488 patients who met inclusion criteria, we defined 2 groups based on their preoperative use of aspirin: those taking (n=282); and those not taking (n=206) aspirin within 5 days of surgery. Measurements and Main Results Binary logistic regression was used to examine relationships among demographic and clinical variables. No significant difference was found between the aspirin and non-aspirin groups with respect to the percentage receiving red blood cell (RBC) transfusion, mean RBC units transfused in those who required transfusion, massive transfusion of RBC, or amounts of fresh frozen plasma, cryoprecipitate, or platelets. Aspirin was not associated with an increase in the rate of re-exploration for bleeding (5.3% vs. 6.3%, P = 0.478). MACE, 30-day mortality, and 30-day readmission rates were not statistically different between the aspirin and non-aspirin treated groups. Conclusions Preoperative aspirin therapy in elective, isolated, valve surgery did not result in an increase in transfusion or re-operation for bleeding and was not associated with reduced readmission rate, MACE, or 30-day mortality.