Objective: The aim of this study was to evaluate the effect of autologous centrifuged residual cardiopulmonary bypass blood on patients' hematocryte value, donor blood product requirements, postoperative blood loss, hospitalization time and the development of infective complications.
Material And Methods: Patients undergoing coronary artery bypass grafting or/and mitral valve procedures were divided into 3 groups. In group I (37 pts.) patients received all blood salvaged from the extracorporeal circuit at the end of cardiopulmonary bypass. In group II (45 pts.) patients blood was not re-infused. In group III (42 pts.) the residual pump blood was collected from the bypass circuit and spun at 2.600 rpm for 10-15 min. The clear upper supernatant was discarded and the remaining concentrated red cells were re-infused back to the patient.
Results: In all three groups hematocryte value during the first hour and postoperative blood loss during the first 12 hours after operation was similar. A higher hematocryte value was found in patients of group III after 12 hours postoperatively as compared with group I and group II (13.2% and 11.1% respectively, p<0.05). Furthermore, 28.57% patients in the group III required a blood transfusion compared with 37.83% patients in the group I and 38.10% patients in the group II (p<0.05). Patients in the group III developed less infective complications as compared with the group II the group I (10.3% and 4.3% respectively). Hospitalization time in group III was decreased in 25.8% as compared with the group I.
Conclusions: We found that autologous centrifuged residual cardiopulmonary bypass blood was useful in avoiding infective complications, decreasing need of donor blood product requirement and postoperative length of stay in the hospital. This method increases hematocryte value after 12 hours postoperatively.
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We present the case of a 74-year-old female patient with a 50 mm ascending aortic aneurysm who underwent ascending aorta replacement. During routine open heart surgery, suboptimal flow in the cardiopulmonary bypass circuit, led to the discovery of a type B aortic dissection with substantial flow in the false lumen. Conservative management was chosen, focusing on blood pressure control in the ICU.
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Department of Paediatric and Congenital Heart Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Rao Saheb, Achutrao Patwardhan Marg, Four Bungalows, Andheri West, Mumbai, Maharashtra 400053 India.
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Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
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Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan.
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