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Ann Thorac Surg 2005;80:1504-1506
© 2005 The Society of Thoracic Surgeons

Case report

Transfusion-Free Complex Cardiac Surgery With Cardiopulmonary Bypass in a 3.55-Kg Jehovah's Witness Neonate

Michael Huebler, MD a , * , Wolfgang Boettcher, ECCP b , Andreas Koster, MD c , Michael Emeis, MD d , Peter Lange, MD d , Roland Hetzer, MD a

a Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
b Department of Perfusion, Berlin, Germany
c Department of Anesthesia, Berlin, Germany
d Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany

Accepted for publication May 3, 2004.

* Address reprint requests to Dr Huebler, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin D-13353, Germany (Email: koster{at}dhzb.de).

Complex cardiac surgery using cardiopulmonary bypass normally requires the transfusion of autologous blood components, particularly in neonates. This is predominately caused by the relatively high priming volume of the circuit with subsequent extreme hemodilution and the often extended and complex perfusions leading to progressive consumption of platelets and coagulation factors. We report on a strategy to minimize the cardiopulmonary bypass circuit and adjust the perfusion technique that resulted in transfusion-free correction of tetralogy of Fallot with an absent pulmonary valve and an aneurysm of the left pulmonary artery in a 3.55 kg Jehovah's Witness neonate boy.




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