[Autohemotransfusion in cardiac reoperations].
OBJECTIVE
To evaluate the efficacy of intraoperative autotransfusion with hemodilution (AHT) to reduce postoperative transfusion of blood or blood products (BT) after cardiac surgery reoperation.


METHODS
Retrospective study, follow-up control.


METHODS
Italian Institution of Cardiac Surgery (IICC).


METHODS
169 patients (51 males, 118 females; mean age 49.5 years) undergoing a reoperation from May 1982 to December 1991.


METHODS
143 patients single valve replacement, 16 patients double valve replacement and 10 patients radical correction for tetralogy of Fallot. AHT (mean 620.2 +/- 226.9 ml) was performed in all patients. The shed blood was reinfused at the end of the surgery. PT, PTT, TT, TT Coagulase, FDP, pre- and postoperative platelet count, bleeding and needs for BT were recorded.


RESULTS
Preoperatively: PT 71.3 +/- 8.1, PTT (sec.) 36.9 +/- 3.5, TT (sec.) 16.2 +/- 2.3, TTC (sec.) 16.9 +/- 1.7, FDP (ng% ml) 3.8 +/- 2.7, Platelet count (No./mu 11 170 +/- 58. Postoperatively: PT 36.5 +/- 6.5, PTT(sec.) 49.5 +/- 8.7, TT(sec.) 19.1 +/- 1.8, TTC(sec.) 18.9 +/- 2.1, FDP (ng% ml) 13.5 +/- 8.9, Platelet count (No./mu 11) 85 +/- 34. We had one reentry because of bleeding. The mean units of blood or blood products need after surgery were 2.2 +/- 1.02. Bleeding from the drainage was 105.2 +/- 103.8. Two patients died in the postoperative period because of low output syndrome. In a period of one year of F.U. we had only one patient with hepatitis B.


CONCLUSIONS
These data suggest that AHT is a safe method, reduces needs for banked blood or blood products, risks of infectious disease transmission and of immunologic reactions and presents hemorheologic benefits because of the diminished blood viscosity.
Actis Dato
G M
GM
Istituzione Italiana di Cardiochirurgia, Torino.
Cirillo
F
F
Actis Dato
A
A
De Benedictis
M
M
Ricci
A
A
D001804:Blood Transfusion, Autologous; D006348:Cardiac Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies
Autoemotrasfusione nei reinterventi in cardiochirurgia.