HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hagop Hovaguimian Ivatury M. Rao Guo-Wei He Gregory A. Meiling Albert Starr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van Son, J. A. M. Articles by Starr, A. Search for Related Content PubMed PubMed Citation Articles by van Son, J. A. M. Articles by Starr, A.

Ann Thorac Surg 1995;59:384-388
© 1995 The Society of Thoracic Surgeons

---

Articles

Strategies for repair of congenital heart defects in infants without the use of blood

The Albert Starr Academic Center for Cardiac Surgery, St. Vincent Hospital and Medical Center, and Emanuel Hospital, Portland, Oregon, USA

Accepted for publication September 20, 1994.

^* Address reprint requests to Dr van Son, Division of Cardiothoracic Surgery, University of California at San Francisco, Room M593, 505 Parnassus Ave, San Francisco, CA 94143-0118.

Eleven infants and children with a body weight of less than 10 kg (median weight, 6.8 kg) whose parents were Jehovah's Witnesses underwent repair (n = 10) or palliation (n = 1) of congenital heart defects without the use of blood products and with (n = 9) or without (n = 2) cardiopulmonary bypass (CPB). In 1 neonate (weight, 3.2 kg) with critical aortic stenosis, moderate hypothermia and a 3.5-minute period of inflow occlusion and circulatory arrest allowed an aortic valvotomy; in another patient (weight, 7.0 kg) with tricuspid and pulmonary atresia, transposition of the great arteries, and persistent left superior vena cava, a bilateral bidirectional cavopulmonary shunt procedure was performed without CPB. Use of heparin-bonded tubing allowed reduction of the initial dose of heparin sodium to 1 mg/kg. Tissue perfusion and oxygenation on bypass were adequate, as evidenced by a mean lowest pH of 7.38 ± 0.09 and a mean lowest venous oxygen tension of 65.0 ± 36.2 mm Hg. Although the mean postoperative hematocrit (Hct) was lower than the mean preoperative Hct (p < 0.05, analysis of variance and Scheffé's F test), the Hct within 2 hours after CPB was restored to a value (mean Hct, 27.5% ± 1.0%) between the preoperative Hct (mean value, 42.7% ± 3.5%) and the lowest Hct on CPB (mean value, 18.4% ± 1.4%). The Hct at discharge was 31.8% ± 1.1%. The median postoperative blood loss was 9 mL/kg. There was no perioperative mortality. The median stay in the intensive care unit and the hospital was 2 days and 6 days, respectively. We conclude that repair of congenital heart defects with the use of CPB can be safely conducted in select infants with a body weight of 5 kg or more. In symptomatic neonates or infants with a lower body weight, initial palliative procedures circumvent the use of CPB and allow secondary correction of the defect at a later time.

This article has been cited by other articles:

				O. Fedevych, K. Chasovskyi, G. Vorobiova, V. Zhovnir, M. Makarenko, A. Kurkevych, A. Maksymenko, and I. Yemets Open cardiac surgery in the first hours of life using autologous umbilical cord blood Eur J Cardiothorac Surg, October 1, 2011; 40(4): 985 - 989. [Abstract] [Full Text] [PDF]

				K. Miyaji, T. Miyamoto, S. Kohira, K. i. Itatani, T. Tomoyasu, H. Sato, and K. Ohara The effectiveness of prestorage leukocyte-reduced red blood cell transfusion on perioperative inflammatory response with a miniaturized biocompatible bypass system J. Thorac. Cardiovasc. Surg., June 1, 2010; 139(6): 1561 - 1567. [Abstract] [Full Text] [PDF]

				K. Miyaji, S. Kohira, T. Miyamoto, K. Nakashima, H. Sato, K. Ohara, and H. Yoshimura Pediatric cardiac surgery without homologous blood transfusion, using a miniaturized bypass system in infants with lower body weight J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 284 - 289. [Abstract] [Full Text] [PDF]

				H. D. Golab, J. J. M. Takkenberg, G. L. van Gerner-Weelink, M. J. Wijers, T. V. Scohy, P. L. de Jong, and A. J. J. C. Bogers Effects of cardiopulmonary bypass circuit reduction and residual volume salvage on allogeneic transfusion requirements in infants undergoing cardiac surgery Interact CardioVasc Thorac Surg, June 1, 2007; 6(3): 335 - 339. [Abstract] [Full Text] [PDF]

				M. Ando, Y. Takahashi, and N. Suzuki Open Heart Surgery for Small Children Without Homologous Blood Transfusion by Using Remote Pump Head System Ann. Thorac. Surg., November 1, 2004; 78(5): 1717 - 1722. [Abstract] [Full Text] [PDF]

				Y. Ootaki, M. Yamaguchi, N. Yoshimura, S. Oka, M. Yoshida, and T. Hasegawa Efficacy of a criterion-driven transfusion protocol in patients having pediatric cardiac surgery J. Thorac. Cardiovasc. Surg., April 1, 2004; 127(4): 953 - 958. [Abstract] [Full Text] [PDF]

				V. Alexi-Meskishvili, S. Ovroutski, I. Dahnert, and T. Fischer Correction of cor triatriatum sinistrum in a Jehovah's Witness infant Eur J Cardiothorac Surg, December 1, 2000; 18(6): 724 - 726. [Abstract] [Full Text] [PDF]