The Tranexaminic acid - Aprotinin - Placebo trial.

Bleeding and the need foor blood transfusions are correlated with increased morbidity, mortality and higher costs. Aprotinin and tranexamic acid have shown to reduce borh blood loss and transfusion requirements during and after cardiac surgery. The efficacy and cost effectivity of tranexamic acid in comparison to aprotinin has been minimally investigated. The few controlled clinical trials that have been performed show a slight benefit of aprotinin over tranexamic acid.

The purpose of this study is to determine which of these pharmacological agents is most efficious and cost effective compared to standard treatment.

We expect that aprotinin will be better in reducing blood loss and transfusion requirements compared with tranexamic acid. However, tranexamic acid will be more cost effective and avoid the risk of anaphylactic shock at reexposeure seen with aprotinin.

N/A

Group A will receive placebo;

Group B will receive high dose aprotinin;

Group C will receive tranexamic acid.

- All medications will be administered during surgery. Anesthetic and surgical procedures in all groups will be carried out according to standard care ;
- All patients will be observed until their discharge, during which time all measurements obtained during standard care will be recorded;

- One blood monster preoperative and four blood monsters will be taken postoperatively to asses for protein concentrations related to SIRS.