title: [Cardiac surgery without transfusion in 2005].
abstract: OBJECTIVE
  Between January 1991 and October 2003, 200 Jehovah Witnesses adult patients underwent elective cardiac surgery. To asses the impact on continuing progress of blood saving protocols and the increasing operative risk of patients proposed to surgery, we have re-assessed our results in this specific population.
  
  
  METHODS
  Files of the first 100 patients operated upon between 1991 and 1998 were reviewed, and compared to the following 100 ones treated between 1998 to today. All patients were scored using the Euroscore model.
  
  
  RESULTS
  In the latest series, patients are older (68 vs 51) and 13% underwent an iterative procedure, although there was none in the first series. Three deaths occurred after one month at the beginning of our experience, only one in the latest series. Operative risk factors had distinctly deteriorated, with more redux, and ejection fraction lower than 35%. Major progress to maintain morbi-mortality stability were multifactorial: preoperative erythropoietin in order to reach an haemoglobin minimal value of 14 g/dL, Cornell University protocol, mini-ECC, warm blood cardioplegia, ultra-early extubation.
  
  
  CONCLUSIONS
  Cardiac surgery without transfusion can be realised with an equivalent risk to that of classical surgery, despite an operative risk aggravation, due to the association of recent conservative techniques.
authors.affiliation: CMC Parly 2, Le Chesnay.
authors.forename: C
authors.initials: C
authors.lastname: Vaislic
authors.forename: O
authors.initials: O
authors.lastname: Bical
authors.forename: P
authors.initials: P
authors.lastname: Deleuze
authors.forename: W
authors.initials: W
authors.lastname: Khoury
authors.forename: D
authors.initials: D
authors.lastname: Gaillard
authors.forename: O
authors.initials: O
authors.lastname: Ponzio
authors.forename: Y
authors.initials: Y
authors.lastname: Ollivier
authors.forename: B
authors.initials: B
authors.lastname: Robine
authors.forename: C
authors.initials: C
authors.lastname: Dupuys
authors.forename: M
authors.initials: M
authors.lastname: Sportiche
mesh_terms: D000367:Age Factors; D000368:Aged; D001803:Blood Transfusion; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors