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Related Concept Videos

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Related Experiment Video

Updated: Jan 8, 2026

Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research
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Predicting bloodless aortic aneurysm repair: A simple point system.

Gift Owolabi1, Kavya Rajesh1, Yanling Zhao2

  • 1Division of Cardiothoracic and Vascular Surgery, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA.

Perfusion
|December 23, 2025
PubMed
Summary

A new scoring tool predicts transfusion-free success in thoracic aortic aneurysm repair for patients refusing blood. Key factors include body surface area and hemoglobin levels, aiding patient counseling and surgical planning.

Keywords:
bloodlesspoint score systempredictive modelproximal aortic aneurysm repairtransfusion

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Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Transfusion Medicine

Background:

  • Patients declining blood transfusions pose challenges in cardiac surgery.
  • Effective preoperative assessment is crucial for managing transfusion-free outcomes.

Purpose of the Study:

  • To develop and validate a preoperative point-based tool for predicting transfusion-free success in open proximal thoracic aortic aneurysm repair.

Main Methods:

  • Retrospective analysis of 1074 patients undergoing open proximal thoracic aortic aneurysm repair.
  • Development of a multivariable logistic regression model to identify predictors of bloodless success.
  • Derivation of a point system based on weighted coefficients of significant preoperative variables.

Main Results:

  • Identified 8 predictors of bloodless repair: body surface area (BSA), hypertension, reoperation, heart failure, baseline hemoglobin, extent of repair, concomitant procedure, and degree of hypothermia.
  • Model showed good discrimination (AUC=0.761), calibration (Brier score=0.192), and balance (F-score=0.758).
  • BSA ≥1.9 m² and hemoglobin ≥13.1 g/dL positively influenced outcomes; proximal + distal extension negatively influenced outcomes.

Conclusions:

  • A novel point-based tool estimates transfusion-free success probability using preoperative factors.
  • The tool aids in counseling patients refusing blood products.
  • It supports perioperative planning and resource allocation for high-risk patients.