Bloodless heart surgery can be a viable option for those patients deemed “inoperable,” who are old or frail, or who can’t have regular heart surgery due to religious reasons. As opposed to traditional heart surgery, bloodless heart surgery actually has certain benefits related to the careful preparation of each patient for bloodless heart surgery, the precise and meticulous technique during surgery, the thorough postoperative follow-up, and the avoidance of potential side effects and complications related to blood transfusions.
Preparation Before Surgery
The preparation before bloodless heart surgery is integral to the success of the procedure. First, Dr. Ciuffo will determine if there is any evidence of spontaneous bleeding or anemia. The most common causes of chronic anemia are related to bleeding from ulcers in the stomach or intestine, bleeding from diverticulosis, heavy menstruations, primary anemias. A hematology or gastroenterology evaluation can be requested as necessary. Next, Dr. Ciuffo will administer medications such as Erythropoietin, Iron, and Folic Acid to stimulate the patient’s production of more red blood cells. Ideally, each patient considered for surgery should be treated to ensure a healthy hemoglobin level. Lastly, your doctor will create a surgical strategy to minimize the risk of bleeding while accomplishing a complete, thorough treatment of the heart condition.
Blood Sparing Techniques
Bloodless heart surgery is known for how minimally invasive it is. Dr. Ciuffo uses techniques that avoid breast bone cutting that could lead to postoperative bleeding. These techniques include:
Extra Corporeal Circulation (the heart-lung machine) with or without blood storage. The entire blood volume can be kept in circulation at all times, in compliance with the principles and beliefs of the Jehovah’s witness community.
Beating Heart Surgery technique for coronary artery bypass. It avoids using the heart-lung machine and helps us maintain a better ability to coagulate and stop bleeding after surgery.
Blood Salvage. A “cell saver” machine filters and returns the patient’s blood to his or her own circulation. A closed circulation loop with no storage can be maintained at all times.
Minimizing Blood Loss
With bloodless heart surgery, blood loss is minimized before and after surgery and Intensive Care Protocols are implemented to manage anemia. Here are some other ways that blood loss is minimized:
Induced Hypothermia decreases the oxygen demands in anemic patients by slowing their metabolism. This will help stabilize anemic patients that need more time to reestablish a good hemoglobin level.
Self-transfusing drainage systems allow Dr. Ciuffo to immediately recover any postoperative bloody drainage in the immediate postoperative period.
Tiny, pediatric test tubes are used to sample a smaller volume of blood and only for absolutely necessary tests. Many hospitals still obtain daily “routine tests” that are not necessary. This old-fashioned practice can cause anemia by drawing up to 20 to 25 cc’s of blood every day. If this is done during a long hospital day, it adds up to a significant blood loss. These mindless routines need to be promptly addressed and corrected as necessary.
Dr. Ciuffo and the Minimally Invasive and Bloodless Heart Surgery Program
Dr. Ciuffo is dedicated to ensuring your heart surgery is successful and that you have a low recovery time. If you have any questions about your open heart surgery or how you should prepare for it, feel free to contact us at (330) 588-4676 or visit our contact page online.