Transfusion Therapy in Reoperative Cardiac Surgery

Chapter

Abstract

Cardiac surgery can be complicated by significant bleeding, particularly in patients with prior cardiothoracic surgery. Redo cardiac procedures can be complicated by adhesions and prolonged cardiopulmonary bypass (CPB), both of which can contribute to excessive bleeding. Approximately 30% of patients undergoing first-time elective coronary artery bypass grafting (CABG) surgery require a blood transfusion (Transfusion 41: 1193–203, 2001), and the likelihood of transfusion is even higher in cardiac reoperations (odds ratio 2.32; confidence interval 1.53–2.33) (Transfusion 46: 1120–9, 2006). Thus, the cardiothoracic surgeon and anesthesiologist need to be aware of the symptoms, signs, relevant laboratory tests, pathophysiology, and management strategies for excessive bleeding in the perioperative period of redo cardiac surgery.

Keywords

Aspirin Heparin Adenosine Anemia Warfarin 

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Pathology, Division of Transfusion MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA

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