Abstract: Massive hemorrhage and allogeneic blood transfusion are common complications in the perioperative period of cardiovascular surgery, which can significantly increase the incidence of adverse events and worsen the long-term prognosis. Therefore, perioperative blood protection strategies have been widely promoted and applied in clinical practice. Additionally, as the core strategy, antifibrinolytic therapy can tremendously reduce perioperative bleeding and blood transfusion during cardiovascular surgery. Tremendous clinical trials have confirmed the efficacy and safety of lysine analog in adult cardiopulmonary bypass cardiac surgery. However, evidence-based medicine on the effectiveness and safety of antifibrinolytic drugs in off-pump cardiovascular surgery and pediatric cardiovascular surgery is still insufficient; there still needs further research and concern. In addition, the topical use of antifibrinolytic drugs and related molecular mechanisms have been reported in recent years. Therefore, this article reviews the efficacy and safety of perioperative antifibrinolytic therapy in cardiovascular surgery.

Key words: cardiac surgical procedures, antifibrinolytic therapy, tranexamic acid