Transfusion free Norwood procedure

PurposeTo reduce and avoid the use of exogenous blood products for neonates and infants, our center limits the use of packed red blood cells and does not use fresh frozen plasma in our cardiopulmonary bypass (CPB) circuit primes. This practice has resulted in several bloodless neonatal open heart surgical procedures including the entire post operative hospital stays. This case report describes a patient with Hypoplastic Left Heart Syndrome who underwent the Norwood procedure without the use of exogenous blood products. No other report of a bloodless Norwood procedure could be found in the literature.MethodsMiniaturized cardiopulmonary bypass circuitry, including shortened arterial and venous lines, minimized modified ultrafiltration and cardioplegia circuits, low holdup volume vents and autologous bypass circuit priming, was used to preserve adequate oxygen carrying capacity at CPB initiation and during the entire surgical procedure.OutcomeNo exogenous blood products were administered to this patient during their entire hospitalization.