Topical Tranexamic Acid: Does it Limit the Blood Loss in Coronary Artery Bypass Graft Surgery Patients?

Suliman Haider; Muhammad Aamir  Khan; Sikandar  Hayat; Muhammad Usama  Akhtar; Ahmad   Ali; Zia Ullah  Safi

doi:10.51253/pafmj.v76iSUPPL-4.14168

Authors

Suliman Haider Department of Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Muhammad Aamir Khan Department of Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Sikandar Hayat Department of Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Muhammad Usama Akhtar Department of Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Ahmad Ali Department of Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Zia Ullah Safi Department of Adult Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-4.14168

Keywords:

Blood Loss, Blood Transfusions, Coronary Artery Bypass, Perioperative Care, Tranexamic Acid

Abstract

Objective: To evaluate the effect of topical Tranexamic Acid (TXA) on postoperative bleeding in on-pump Coronary Artery Bypass Graft (CABG) surgery patients.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Mar to Nov 2025.

Methodology: Using consecutive sampling, ninety patients, both genders, aged between 40-70 years, who were scheduled for elective on-pump CABG, were enrolled. Patients who had redo or emergency CABG, valvular or combined procedures, and those with bleeding disorders, chronic liver or kidney disease, an ejection fraction <40%, recent anticoagulation or antiplatelet therapy, or suffered intraoperative complications were excluded. Patients were assigned into two groups: the TXA-Group (n=45) received 2 g TXA/100 mL saline for pericardial and mediastinal washing, while the Control-Group (n=45) received only 100 mL saline. The groups were analyzed for postop blood loss and blood transfusions at 6, 12, and 24 hours.

Results: The mean age of the participants was 58.67±9.04 years, with males comprising 71.1% of the study population. Postoperative blood loss was significantly reduced in the tranexamic acid (TXA) group compared with the control group across all evaluated time points. At 6 hours postoperatively, median blood loss was 60.00 mL (IQR: 40.00–120.00) in the TXA group versus 180.00 mL (IQR: 70.00–280.00) in the control group (p=0.001).......

Conclusion: Patients who did not receive topical TXA before chest closure had a significantly higher postoperative bleeding. Moreover, it is an effective and economical way for controlling non-surgical ....

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