Bloodless Heart Surgery


NEW YORK, N.Y. (Ivanhoe Newswire) – There are 500,000 open heart surgeries done in the United States every year and half of those patients require a blood transfusion. But what if you’ve had a complication during a transfusion in the past, or if your religion forbids it?

It is a major, life-saving procedure but it can also cause significant blood loss – open heart surgery presents special challenges for patients who must avoid blood transfusions. Mount Sinai cardiovascular surgeon, John Puskas, MD says one key is to prepare well before the patient is wheeled into the OR.

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“We give patients something called erythropoietin – a hormone that increases their blood counts prior to surgery,” Dr. Puskas explains.

For bypass patients, Dr. Puskas and his colleagues can use a new surgical technique.

Dr. Puskas further explains, “We do this all arterial, no aortic touch operation, meaning we don’t connect any of the bypass grafts to the aorta.”

By avoiding the aorta, doctors minimize blood loss. The no-touch bypass surgery means they can also avoid putting a patient on a heart-lung machine, which lowers the risk of blood loss. And if patients do lose blood, doctors use a medical procedure to safely recycle it.

“Washed,centrifuge and returned to the patient, so that we use these cell savers or cell salvage devices in the operating room,” Dr. Puskas adds.

There are now about 100 hospitals in the United States with specialized programs that can accommodate bloodless or transfusion-free surgeries. People who are practicing Jehovah’s Witnesses and Christian Scientists have religious beliefs that require them to avoid transfusions. Some people have conditions that cause allergic reactions to blood during transfusions.

Contributors to this news report include: Cyndy McGrath, Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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Dr. John Puskas, Mount Sinai, NY




REPORT:       MB #5193

BACKGROUND: Heart surgery is done to correct problems with the heart. Your provider may recommend surgery after lifestyle changes, medicines, or other procedures no longer work. Heart surgery may also be done in an emergency situation, such as a heart attack. Each year, more than 2 million people around the world have open-heart surgery to treat various heart problems. Depending on your heart problem, your healthcare provider may suggest different types of heart surgery. These can range from minimally invasive surgical options to open-heart surgeries that may require a longer recovery time. Before surgery, your provider may order tests to determine which type of heart surgery will work best for you.


DIAGNOSING: Some signs and symptoms that may need to be resolved by heart surgery are: chest pain, palpitations or abnormal heart rhythms, fatigue, foot or hand swelling, shortness of breath, and/or indigestion. These symptoms typically only appear late in the progression of heart disease when there is already enough of a blockage to cause symptoms. Treatments such as CABG can reduce coronary artery blockages and prevent a heart attack. Several diagnoses will make you a candidate for coronary bypass surgery. Doctors will first need to learn what area of your heart is affected. They may perform any of the following tests: EEG, echocardiogram, stress test, cardiac catheterization/angiogram.


NEW PROCEDURE: Bloodless cardiac surgery is a safe alternative for patients who have serious heart conditions but cannot or choose not to receive any blood or blood products (red cells, white cells, plasma or platelets). During bloodless heart surgery, physicians use innovative procedures that minimize surgical blood loss and avoid the need for a transfusion during surgery. Doctors work with each patient individually to develop a personalized bloodless surgery strategy.



Ilana Nikravesh

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Doctor Q and A

Read the entire Doctor Q&A for John Puskas, MD Cardiovascular surgeon

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