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J Thorac Cardiovasc Surg 2003;126:918-919
© 2003 The American Association for Thoracic Surgery

Brief communications

Controlled exsanguination during sternal reentry

^a Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Received for publication October 16, 2002; accepted for publication November 8, 2002.

^* Address for reprints: Alejandro Aris, MD, PhD, Cardiac Surgery Service, Hospital de la Santa Creu i Sant Pau, Avenida San Antonio M. Claret 167. 08025 Barcelona, Spain
aaris@hsp.santpau.es

The first 20% of the full text of this article appears below.

Alejandro Aris, MD, PhD

Sternal reentry can cause catastrophic hemorrhage. Several maneuvers have been advocated to reduce this risk.^1-4 The new simple method of heart decompression during sternal reentry described here is based on controlled exsanguination (1500 mL of blood) through a long venous cannula before sternal opening, with rapid retransfusion through the same cannula. This technique avoids femoral artery cannulation.

Patients and methods

Patient data
Twelve patients underwent reoperation with this technique at my institution. All were subjected to valvular reoperations. Surgical procedures included 4 mitral valve replacements combined with tricuspid annuloplasty, 3 aortic valve replacements (2 with tricuspid annuloplasty), 1 tricuspid valve replacement, 2 repairs of a mitral periprosthetic leak, 1 mitral valve rereplacement because of pannus formation, and 1 double valve replacement for prosthetic endocarditis. It was the third operation for 1 patient and the fourth for another.

Surgical technique
After the skin was opened, the sternal wires were untwisted. The femoral vessels were exposed through a . . . [Full Text of this Article]

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