Strategic and operational aspects of a transfusion-free neonatal arterial switch operation.

Martin Schweiger, Hitendu Dave, Janet Kelly, Michael Hübler

Journal: Interactive cardiovascular and thoracic surgery 2013;16(6):890-1

PMID: 23460601

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Abstract

Blood transfusion-free complex congenital cardiac surgery in a neonate remains a challenge for multidisciplinary cardiac teams. At our institution, a 3.5 kg neonate, born to a family of Jehovah's Witnesses and postnatally diagnosed with dextro-transposition of the great arteries (d-TGA) and a small muscular ventricular septal defect, underwent a successful arterial switch operation without blood or platelet transfusion. Key points that contributed to success were optimal preoperative haematopoetic conditioning using erythropoietin and iron, a miniaturized cardiopulmonary bypass circuit including a low prime volume oxygenator and crystalloid cardioplegia, and a well-coordinated multidisciplinary team. We report an overview of the literature regarding blood transfusion-free complex congenital cardiac surgery.

Address: Department of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.

DOI: 10.1093/icvts/ivt010