Bloodless aortic valve and ascending aorta replacement surgery requiring circulatory arrest: two case studies.
Blood and/or blood product transfusions are common during and after complicated cardiac procedures. Replacement of the aortic valve, ascending aorta, and coronary implantation requiring circulatory arrest are high-risk procedures. Blood product transfusions only add to the morbidity and mortality rates associated with these types of procedures. Perfusion strategies must be incorporated to decrease the effects of hemodiluton due to cardiopulmonary bypass (CPB), and preserve platelets and clotting factors needed for hemostasis, post-operatively. We are reporting two consecutive cases where the patients presented with aortic valve stenosis accompanying an ascending aortic aneurysm requiring surgical correction using circulatory arrest. Neither patient required any blood or blood product donation throughout their hospital stay. Our strategies included minimizing our bypass circuit, utilization vacuum-assisted venous drainage, plasma sequestration, total circuit retrograde autologous priming (RAP), and cell salvage.
Schill
David M
DM
Cardiovascular Insights LLC at Holmes Regional Medical Center, Melbourne, Florida, USA. fldsunshine@hotmail.com
D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male