title: Strategic and operational aspects of a transfusion-free neonatal arterial switch operation.
abstract: Blood transfusion-free complex congenital cardiac surgery in a neonate remains a challenge for multidisciplinary cardiac teams. At our institution, a 3.5 kg neonate, born to a family of Jehovah's Witnesses and postnatally diagnosed with dextro-transposition of the great arteries (d-TGA) and a small muscular ventricular septal defect, underwent a successful arterial switch operation without blood or platelet transfusion. Key points that contributed to success were optimal preoperative haematopoetic conditioning using erythropoietin and iron, a miniaturized cardiopulmonary bypass circuit including a low prime volume oxygenator and crystalloid cardioplegia, and a well-coordinated multidisciplinary team. We report an overview of the literature regarding blood transfusion-free complex congenital cardiac surgery.
authors: Department of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.
authors: Martin
authors: M
authors: Schweiger
authors: Hitendu
authors: H
authors: Dave
authors: Janet
authors: J
authors: Kelly
authors: Michael
authors: M
authors: Hübler
mesh_terms: D015415:Biomarkers / Q000097:blood; D001804:Blood Transfusion, Autologous; D057668:Bloodless Medical and Surgical Procedures / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000008:administration & dosage; D007722:Health Knowledge, Attitudes, Practice; D006324:Heart Arrest, Induced; D006397:Hematinics / Q000008:administration & dosage; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007501:Iron / Q000008:administration & dosage; D033221:Jehovah's Witnesses / Q000523:psychology; D008297:Male; D057725:Operative Blood Salvage; D012068:Religion and Medicine; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D004921:Erythropoietin; D007501:Iron
keywords: Arterial switch operation; Blood transfusion-free; Congenital cardiac surgery; Jehovah's Witness