doi:10.1016/j.ejcts.2011.05.031 Is tranexamic acid really an alternative to aprotinin?

acid as an adequate alternative to aprotinin for antifibrinolytic therapy in pediatric congenital heart surgery. They compared post-operative blood loss and transfusion requirements between two periods of time – a former one with aprotinin and a later one with tranexamic acid – and noted no difference. This conclusion cannot be drawn from their results. The precondition for such study must be that the aprotinin and the tranexamic acid groups are compar-able. This precondition is more than questionable because there are striking differences between the two groups: significant differ-ences were observed in the preoperative coagulation values (Table 1), the time of aortic clamping and the amount of intrao-perative platelets (Table 2), the postoperative fluid balance (Table 3) and the postoperative coagulation values (Table 4) [1]. For example, the higher preoperative laboratory values of fibrinogen and platelets favour the aprotinin group, whereas the highe