Open Heart Surgery without Homologous Blood Transfusion for Cyanotic Congenital Heart Diseases

(Department of Surgery and Department of Pediatrics*, Sakakibara Heart Institute, Fuchu, Japan)

Naoki Wada Yukihiro Takahashi Makoto Ando
Toshio Kikuchi Hitomi Boku*
We evaluated our results of open heart surgery without blood transfusion in patients undergoing definitive repair for cyanotic congenital heart diseases between January 1997 to October 2003. Procedures included arterial switch operation for those weighing more than 4kg (n8: group A), modified Fontan procedure (n52: group B), atrioventricular septal defect with tetralogy of Fallot repair (n9: group C), and Rastelli procedure (n27: group D). Patients undergoing repair for tetralogy of Fallot (n108) was the reference group (group E). The success rate was 100% (8/8) in group A, 94.2% (49/52) in group B, 89% (8/9) in group C, and 85.2% (23/27) in group D, which was comparable with group E, 97.2% (105/108). Our strategies included use of low-priming volume cardiopulmonary bypass circuit and autologous blood donation collected after anesthetic induction. All groups had comparable postoperative outcomes, with low mortality and morbidity. Early extubation was achieved in the majority of cases. In conclusion, open heart surgery was safely performed without blood transfusion in cyanotic congenital heart disease.
@Jpn. J. Cardiovasc. Surg. 34: 83-87 (2005)