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Eur J Cardiothorac Surg 2001;20:233-238
© 2001 Elsevier Science NL

Usefulness of vacuum-assisted cardiopulmonary bypass circuit for pediatric open-heart surgery in reducing homologous blood transfusion

Department of Cardiovascular Surgery, Hiroshima City Hospital, Hiroshima, Japan

Received 10 November 2000; received in revised form 17 April 2001; accepted 25 April 2001.

Corresponding author. Present address: Department of Cardiovascular Surgery, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Tel.: +81-86-223-7151; fax: +81-86-225-7143
e-mail: koji_15{at}sannet.ne.jp

Objective: Open-heart surgery without homologous blood transfusion is still difficult in children because priming volume in cardiopulmonary bypass circuit results in extreme hemodilution. Vacuum-assisted cardiopulmonary bypass circuit has the benefit of improving venous return and results in lowering priming volume. We introduced vacuum-assisted cardiopulmonary bypass circuit in order to reduce priming volume for pediatric patients in March 1995. A retrospective study was made on the efficacy of vacuum-assisted circuit for pediatric open-heart surgery in reducing homologous blood transfusion. Methods: Patients weighing from 5 to 20 kg who underwent surgery between January 1991 and June 1996 were divided into two groups, group A comprised 128 patients before introduction of this circuit and group B comprised 49 patients after introduction, and their clinical course was compared. Vacuum-assisted circuit was used in 27 patients of group B. Results: The percentage of transfusion-free operations was significantly higher in group B than in group A (33.6% in group A vs. 53.1% in group B, P=0.014), and particularly this percentage in patients weighing less than 10 kg significantly increased (0% in group A vs. 42.9% in group B, P<0.01). The amount of homologous blood transfusion was significantly lower in group B than in group A (374±362 ml in group A and 212±287 ml in group B, P<0.01). The rate of complications and the duration of respiratory support did not differ between the two groups. The duration of hospital stay was lower in group B than in group A. Conclusions: The findings of this study indicate that vacuum-assisted circuit is useful for pediatric open-heart surgery in reducing homologous blood transfusion.

Key Words: Cardiopulmonary bypass • Open heart surgery • Infant • Blood transfusion

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