[Open heart surgery with bloodless priming for cyanotic congenital heart diseases--the role of autologous blood donation after induction of anesthesia].

In 50 patients with cyanotic congenital heart diseases, open heart surgery was conducted with bloodless priming from January 1994 to August 1995. Surgical procedures included the Rastelli procedure (n = 14), the modified Fontan procedure (n = 10), and intracardiac repair of TOF (n = 26). The non-transfusion rate from January 1994 to August 1994 was 17% (1/6) in the Rastelli group, 67% (2/3) in the Fontan group, and 67% (8/12) in the TOF group. Autologous blood donation immediately after induction of anesthesia was carried out from September 1994 because post-operative hemorrhage and severe hemolysis of residual blood of the pump required conventional blood transfusions up to August. Autologous blood of 12 +/- 2 ml/kg could be collected, and the non-transfusion rate from September 1994 to August 1995 was increased to 75% (6/8) in the Rastelli group, 86% (6/7) in the Fontan group, and 93% (13/14) in the TOF group. There were no complications due to asanguineous extracorporeal circulation or autologous blood donation, and the post-operative hemodynamic and respiratory status were uneventful in almost all cases. We conclude that open heart surgery without blood transfusion is feasible in more than 70-80% patients who undergo the Rastelli procedure, the modified Fontan procedure or intracardiac repair of TOF. Autologous blood donation after induction of anesthesia proved to be highly effective method for reducing conventional blood transfusion.