Objective
We performed a systematic review and meta‐analysis of randomized clinical trials on adult patients undergoing cardiac surgery and compared the rates of red blood cell (RBC), platelet and fresh frozen plasma (FFP) transfusion between the cell saver (CS) and the standard of care groups.
Methods
MEDLINE ®, The Cochrane Central Register of Controlled Trials (CENTRAL), American Society of Hematology (ASH) and bibliographies of relevant studies were searched. We used random‐effect model.
Results
Our search strategy returned 624 citations, of which 15 studies were selected. The use of CS did not decrease the rate of RBC transfusion (odds ratio [OR]: 0·69; 95% CI: 0·48–1·00), albeit with a substantial heterogeneity (I2 = 60%). The year of publication explained most of the heterogeneity (P for subgroup effect <0·001). Although the rate of platelet transfusion was lower in the CS group, the difference was not statistically significant (OR: 0·83; 95% CI: 0·57–1·2; I2 = 0%). The rate of FFP transfusion was numerically higher in the CS group; however, this difference did not reach statistical significance (OR: 1·26; 95% CI: 0·82–1·94; I2 = 15%). Only two studies scored five on the Jadad score. There was no indication of a publication bias using the funnel plot and Egger test (P = 0·34, 0·87, and 0·62 for RBC, platelet and FFP, respectively).
Conclusion
The use of CS during cardiac surgery does not have an impact on the rates of RBC, platelet and FFP transfusion; however, this should be interpreted in the light of the study limitations.
Proper detection of the deeply embedded left anterior descending artery remains a challenge. Many authors proposed different methods for artery identification, such as ultrasound Doppler, cineangiography, retrograde dissection overlying tissues, and exposure over the probe. Choice of the technique often depends on the surgeon's acquaintance and experience. The article compares and summarizes different procedures for the detection of intramyocardially located left anterior descending artery.
The risk of thrombosis is high in patients with essential thrombocythemia. Special precaution needed for those patients who will undergo Coronary artery bypass grafting. We are reporting a 62 years old patient with ischemic heart disease who was found to have essential thrombocythemia. This report explains the preoperative management and the postoperative risks anticipated due to the treatment.
We report the successful surgical treatment of a case of double drainage of the right upper pulmonary vein into the superior vena cava and left atrium in a 9-year-old girl.
A few cases of coronary artery bypass surgery in patients with dextrocardia and situs inversus have been reported so far worldwide. This is the first reported case from the Gulf region. The operation was performed with the surgeon standing on the left side. Grafts included right internal mammary artery to the left anterior descending artery, and saphenous vein to the diagonal and obtuse marginal arteries. The patient was discharged home after 12 days, with no complication. He was doing well after 3 months of follow-up.
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