Open Cardiac Surgery without Blood and Blood Products Transplantation

Abstract

We have performed a total of 138 cases; no blood and blood products were transfused in 71% (n = 98), and in 29.0% (n = 40) blood and blood products were transfused. Thirty-day mortality and morbidity (arrhythmia, infectious and pulmonary morbidity, myocardial infarction, cerebrovascular accident, renal dysfunction, sternal revision) were compared between these two groups and no statistically significant difference was observed. Patients' awakening, extubation time, cardiopulmonary bypass period, cross-clamp time, and days in intensive care unit and hospital were compared, and there was no statistically significant difference between the two groups. Conclusion: In this study, we conclude that open heart surgery without blood transfusion may be accomplished with decent peri/postoperative management. The patients who did not receive any blood or blood products were not compromised clinically or hemodynamically. No extra morbidity and mortality were seen in the non-transfusion group. Transfusion decision was based on clinical and hemodynamic parameters such as persistent hypotension or tachycardia, hyperlactatemia, low urine output, and anemic symptoms.

Open Heart Surgery at Patient’s Own Temperature Without Active Cooling

“…The amount of hemorrhage and transfusion required in hypothermic patients during CPB was reported higher than in normothermic patients in recent studies [Ho 2011;Rasmussen 2007]. Since we consider blood transfusion to be a type of tissue transplantation, we perform open heart surgery without using blood and blood products in our clinical practice to avoid transfusion-related side effects as much as possible, as reported in a previous study [Kaplan 2017].…”

A New Arterial Cannulation Technique: Arterial Cannulation through Aortic Anastomosis (“Kaplan” Technique)

“…hemoglobin values but also on the hemodynamic and clinical parameters of our patients [Kaplan 2017]. By this method, we did not use any blood or blood products also for this patient.…”

Optimal Blood Transfusion Practice in Cardiac Surgery

“…An analysis of transfusion practice in Australian hospitals revealed that transfusion rates varied across hospitals from >1 RBC unit from 22% to 67% and >5 RBC units from 5% to 25%, with the hospital characteristics having no bearing on this practice. 31 No doubt, appropriate use of allogeneic blood can be lifesaving, but many transfusions are not only unnecessary but can be harmful. 32 This becomes even more relevant in a scenario in which the patient is more likely to experience bleeding, such as during cardiac surgery.…”