Tranexamic Acid Use In Cardiac Surgery: A Review On Indications, Dosage, And Complications

It has been demonstrated that cardiovascular diseases are one of the most common causes of death in humans; therefore, various prevention and treatment measures are being taken by the medical community in this regard. For a long time, various treatments have been recommended, including surgeries, but these methods may have a number of complications that the most important of which is bleeding after surgery. Therefore, preserving patient's blood during heart surgery is very important. Due to the high number of patients undergoing heart surgery and the high probability of using blood products, regardless of the costs to be paid, there is a wide range of known and unknown and at the same time unwanted complications and conditions that can be caused by blood transfusions. Therefore, researchers have conducted several studies to find ways to preserve the blood of patients undergoing heart surgery, including the use of drugs such as tranexamic acid (TXA). TXA is a synthetic analogue of the amino acid lysine and an anti-fibrinolytic compound that competitively inhibits plasminogen-to-plasmin activation. This compound non-competitively blocks plasmin at high concentrations, thus TXA prevents the dissolution and destruction of fibrin clots by plasmin. Extensive review of literature has shown that TXA has prevented bleeding in multiple trials without increasing the risk of thrombosis and has a wide range of clinical uses. Despite the role of tranexamic acid in reducing postoperative bleeding, however, the use of this drug will have several side effects. Due to the contradictory results of different literature related to the use of this drug in reducing bleeding and also reducing the need for blood transfusion in patients undergoing surgery, the present review study was conducted to investigate the literature on this subject.

Keywords:

Tranexamic Acid , Cardiac Surgery , Antifibrinolytic Agents , Blood Conservation.