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Review
. 2013 Jun;16(6):890-1.
doi: 10.1093/icvts/ivt010. Epub 2013 Mar 4.

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

Martin Schweiger  1 , Hitendu Dave, Janet Kelly, Michael Hübler
Affiliations
Review

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

Martin Schweiger et al. Interact Cardiovasc Thorac Surg. 2013 Jun.

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.

Keywords: Arterial switch operation; Blood transfusion-free; Congenital cardiac surgery; Jehovah's Witness.

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Figures

Figure 1:
Figure 1:
Course of haemoglobin (Hb) and haematocrit (Hct) levels; CPB: cardiopulmonary bypass; POD: postoperative day.
See this image and copyright information in PMC

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