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Published on: September 15, 2023
Coronary artery bypass surgery without blood transfusion; is it possible?
K Aykut1, G Albayrak1, Y Cetin2
1Department of Cardiovascular Surgery, Izmir Medicalpark Hospital, Izmir University of Economics, Izmir, Turkey.
Insights
This study shows that a triple combination technique significantly reduces the need for blood transfusions in coronary artery bypass surgery patients. Most patients avoided transfusions, making the method safe and effective.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Anesthesiology
Background:
- Coronary artery bypass surgery frequently requires blood transfusions (40-70%) despite surgical advancements.
- Preventive strategies include acute normovolemic hemodilution, retrograde autologous priming, and integrated arterial filter oxygenators.
Purpose of the Study:
- To evaluate the efficacy of a combined triple technique in avoiding blood transfusions during coronary artery bypass surgery.
- To assess the safety and cost-effectiveness of this novel approach in adult patients.
Main Methods:
- A randomized controlled trial involving 300 adult patients undergoing coronary artery bypass surgery.
- Group 1 (150 patients) received the triple combination technique.
- Group 2 (150 patients) received standard cardiopulmonary bypass techniques.
Main Results:
- 92% of patients in the triple combination group avoided blood transfusions.
- Only 8% required erythrocyte suspension or fresh frozen plasma.
- A statistically significant reduction in transfusion rates compared to the standard group (58% transfusion rate).
Conclusions:
- The triple combination technique is a safe and cost-effective method for coronary artery bypass surgery.
- This technique enables most patients to undergo surgery without the need for blood transfusions.
Background:
Coronary artery bypass surgery is the most commonly performed cardiac operation and approximately 40-70% of patients require a blood transfusion despite improvements in cardiac surgical techniques. Some preventive perfusion methods to avoid transfusions are described, such as acute normovolemic hemodilution, retrograde autologous priming, and usage of integrated arterial filter oxygenator.
Aims:
We combined these three techniques (triple combination technique) to evaluate whether it is possible to avoid blood transfusions in adult patients undergoing coronary artery bypass surgery.
Materials And Methods:
A total of 300 consecutive patients were included in this randomized controlled trial. 150 patients (Group 1) were operated with triple combination technique, The other 150 patients (Group 2) were operated with standard cardiopulmonary bypass technique. The two groups were compared in terms of peroperative and postoperative blood product use.
Results:
Ninety-two percent (92%) of the patients (Group 1) undergoing coronary artery bypass surgery did not require any blood transfusion. Only 8% of the patients required erythrocyte suspension or fresh frozen plasma transfusion. In Group 2, 58% of patients required blood transfusions. The difference between two groups was statistically significant (p < 0,05).
Conclusion:
Triple combination technique is safe and cost-effective in coronary artery bypass surgery. We think that most of the patients could be operated without blood transfusion with this technique.
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