The bloodless heart surgery program at St. Joseph's Hospital is designed to minimize blood loss before, during and after open-heart surgery. This eliminates the need for blood transfusions (stored or donated blood products), which can cause side effects in some patients.
Benefits to patients
- Reduces complications and length of hospital stay
- Eliminates the potential side effects of donated blood
- Supports patients who - for personal, ethical or religious reasons - do not wish to use blood or blood products
- Improves long-term survival after heart surgery
Preparing for bloodless surgery
Our bloodless program involves special care before and after surgery. It also uses specific processes during and after surgery to minimize blood loss.
If you have anemia (a low number of red cells in your blood), you will be prescribed medicine before surgery to stimulate red blood cell production. We also reduce blood loss by minimizing the number of tests as well as the amount of blood used for tests before and after surgery.
Blood conservation techniques during surgery include salvage of shed blood recovered in IV bags to give the patient back their own blood. We take steps both during surgery and afterward to decrease bleeding and follow strict guidelines for blood transfusions.
Helpful definitions relating to bloodless surgery
Albumin – Helps to expand blood volume. A protein extracted from plasma. Types of albumin are found in plants, foods such as milk and eggs, and in the milk of nursing mothers. Albumin from blood is sometimes used to expand the volume of blood to treat shock. This protein is sterilized by heating to 40° C and is suspended in saline solution. It is given intravenously (by IV).
Autologous transfusion – Transfusion of a patient's own blood. During surgery, as with cell salvage (see definition below), blood is collected from a vein, diverted to bags, and stays in continuous contact with the patient. At the end of surgery it is re-infused to the patient.
Cell salvage – Reduces blood loss. Blood is recovered during surgery from a wound or body cavity into IV bags in a continuous process, connected to a patient, similar to a heart-lung machine and then returned to the patient.
Fresh frozen plasma – Maintains clotting factors. Also has Human Factor but no red cells.
Heart-lung machine – Maintains circulation and lung function. Blood is diverted to an artificial heart-lung machine where it is oxygenated and directed back into the patient. A smaller pump, called the "mini-circuit," uses 60% less fluid/blood and is available for surgeons to use at St. Joseph's Hospital. Learn more on the Open-Heart Surgery page.
Platelets – Small particles in the bloodstream that help blood to clot.
Ultrafiltration – Similar but more simple than dialysis. Blood circulates through a hemofilter in continuous contact with the patient, to remove excess fluid from the patient before returning blood to the patient.
Volume expanders – Increases the volume of blood. These increase the volume of blood by increasing the volume of plasma. Hespan (or hetastarch) is a plasma volume expander derived from natural sources of starch. It is given intravenously.