"Asanguinous" Open-Heart Surgery

Abstract

"Asanguinous" open-heart surgery was initially performed by our team at our institution in January 1982 for mitral valve replacement in a Jehovah's Witness, whose religious beliefs precluded blood transfusion. Since then, we have applied this principle to all of our open-heart cases, with excellent results. Using an IBM 2991 blood cell processor and Sorensen Autologous Transfusion System, our institution has salvaged an average of 92.1 units of blood per month, from January 1982 to December of 1983, with a total of 650 units for 1982 and 1105 units for 1983. From January to August of 1984, a total of 645 units were saved, with an average of 80 units per month. This protocol involved 1121 patients with coronary bypass surgery, 32 of which had concommitant repair of IV aneurysm, and 27 with unilateral carotid endarterectomy. One hundred and sixty-eight underwent cardiac valve replacement, 109 mitral, 57 aortic, and 2 combined MVR-AYR. Eighty-six percent of our entire series did not require homologous, transfusion, other than their own, individual salvaged packed cells. "Asanguinous" open-heart surgery is not only possible and safe, but also a medically prudent technique that is cost-efficient and devoid of the usual hazards associated with homologous transfusion.