Bloodless Operations in the Surgical Treatment of Mitral-Aortic Heart Disease in Conditions of Artificial Circulation

  • B. M. Gumeniuk National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  • V. V. Popov National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
Keywords: surgical treatment of mitral-aortic heart disease, blood-saving technology, artificial blood circulation

Abstract

Traditional mitral and aortic valve replacement in conditions of artificial blood circulation (ABC) involves the use of blood products. Given various complications arising in perioperative period, the authors propose a technique for “bloodless operations” without the use of donor blood, without the use of columns, and the “sell-saver” method. From January 1, 2011 to December 31, 2018, mitral-aortic valve replacement was performed in 79 patients; in 42 of them blood products were used during surgery, and in 37 patients donor blood components were not used. The method of anaesthetic and infusion-perfusion measures for mitral-aortic valve replacement in conditions of ABC is given. The use of the blood-saving method has allowed to obtain good clinical effect without transfusion complications in perioperative period, which facilitated the use of bloodless methods for mitral-aortic valve replacement in the main group in conditions of ABC and reduce blood transfusions in perioperative period from 27.4 % to 10.3 % of the circulating blood volume (CBV), compared to the control group. In the variant of reservation of autoblood “A+B+C” and exfusion of 27.2% of the CBV, the most effective variants of the blood-saving) technology were observed during mitral-aortic valve repair in conditions of ABC.

References

  1. Gumenyuk BM. [Detection of Markers of Infections that are Transmitted Through donors Blood to Cardiac Surgery Patients Hospital]. Annual of scientific works of the Association Ukrainian of Cardiovascular Surgeons of Ukraine. 2011;19:83–7.
  2. Jin R, Zelinka ES, McDonald J, Byrnes T, Grunkemeier GL, Brevig J; Providence Health & Services Cardiovascular Disease Study Group. Effect of hospital culture on blood transfusion in cardiac procedures. Ann Thorac Surg. 2013; 95:1269–74. https://doi.org/10.1016/j.athorac-sur.2012.08.008
  3. Dietrich W, Lu #th JU, Kormann J, Wick S, Kaiser W, Eberle B, et al. [Intraoperative blood requirements and allogeneic blood transfusion in cardioanesthesia. Data analysis of 7729 patients in 12 cardiac surgical clinics]. Anaesthesist.1999; 48(12):876–83. German.
  4. Curley GF, Shehata N, Mazer CD, Hare GM, Friedrich JO. Transfusion triggers for guiding RBC transfusion for cardiovascular surgery: a systematic review and meta-analysis. Crit Care Med. 2014;42(12):2611–24. https://doi.org/10.1097/CCM.0000000000000548
  5. Cote C, MacLeod JB, Yip AM, Ouzounian M, Brown CD, Forgie R, et al. Variation in transfusion rates within a single institution: exploring the effect of differing practice patterns on the likelihood of blood product transfusion in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2015;149:297–302. https://doi.org/10.1016/j.jtcvs.2014.09.004
  6. Kozek-Langenecker SA, Ahmed AB, Afshari A, Albaladejo P, Aldecoa C, Barauskas G, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: first update 2016. Eur J Anaesthesiol. 2017;34:332–95. https://doi.org/10.1097/EJA.0000000000000630
  7. Shander A, Ferraris VA. More or less? The Goldilocks Principle as it applies to red cell transfusions. British Journal of Anaesthesia. 2017; 118(6):816–9. https://doi.org/10.1093/bja/aex135.
  8. Lazorishinetz V., Popov V., Gumenyuk B., Dyachenko V. [Bloodsaving technology in surgery of mitral heart defects]. Cardiology in Belarus. 2016;8(3):21–5. Russian.
Published
2020-03-24
How to Cite
Gumeniuk, B. M., & Popov, V. V. (2020). Bloodless Operations in the Surgical Treatment of Mitral-Aortic Heart Disease in Conditions of Artificial Circulation. Ukrainian Journal of Cardiovascular Surgery, (1 (38), 32-36. https://doi.org/10.30702/ujcvs/20.3803/006032-036