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[Heart surgery without blood transfusion].

E Ovrum1, E A Holen, M A Lindstein-Ringdal

  • 1Hjertesenteret i Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|February 28, 1990
PubMed
Summary
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Comparison of two heparin-coated extracorporeal circuits with reduced systemic anticoagulation in routine coronary artery bypass operations.

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Rapid recovery protocol applied to 5,658 consecutive "on-pump" coronary bypass patients.

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[Coronary surgery at the Heart Center in Oslo 1989-98].

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Leucocyte filtration during cardiopulmonary reperfusion in coronary artery bypass surgery.

Perfusion·1999

Open heart surgery, specifically coronary artery bypass operations, can be safely performed without homologous blood transfusions. A strict blood conservation program achieved this in 100 consecutive patients.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Transfusion Medicine

Context:

  • Blood conservation is crucial in open heart surgery to minimize risks like viral contamination and manage resource limitations.
  • Coronary artery bypass grafting (CABG) traditionally involves significant blood product usage.

Purpose:

  • To evaluate the feasibility and outcomes of performing elective CABG without homologous blood transfusions.
  • To assess the efficacy of a comprehensive blood conservation protocol in a large patient cohort.

Summary:

  • 100 consecutive CABG patients (13 female/87 male, aged 33-73) underwent surgery using a strict blood conservation program.
  • The protocol included pre-operative autologous blood removal, retransfusion of heart-lung machine contents, and postoperative autotransfusion of mediastinal blood.

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  • No patients required homologous blood; all survived, were extubated rapidly (mean 1.6 hours), and did not need resternotomy for bleeding. Five patients received fresh frozen plasma for coagulopathy.

    • Impact:

    • Demonstrates that elective CABG can be performed with minimal or no homologous blood transfusions, enhancing patient safety and resource management.
    • Highlights the success of a multi-component blood conservation strategy in a real-world surgical setting.
    • Provides evidence supporting the wider adoption of bloodless surgery techniques in cardiac procedures.