Penn Heart and Vascular

Quality and Outcomes at the Bloodless Cardiac Surgery Program

Quality & Outcomes

The Bloodless Cardiac Surgery Program at Pennsylvania Hospital offers a wide range of complex cardiovascular surgeries for patients who cannot have blood transfusions. Bloodless cardiac surgery involves meticulous surgical technique. From preparation through recovery, successful bloodless surgery demands the talents of a very experienced, multispecialty team. Penn cardiovascular surgeons have mastered the skill and precision necessary to perform bloodless and blood-conserving procedures and have taken a role in educating surgeons throughout the world about blood conservation techniques.

Patient Population Requiring Bloodless Cardiac Surgery FY 2000 - FY 2010, N = 91

Year AVR CABG CABG + Valve Other Valve Totals
2000 0 2 0 0 0 2
2001 0 1 0 0 0 1
2002 1 2 0 0 0 3
2003 0 2 0 1 0 3
2004 1 3 1 0 0 5
2005 3 3 0 0 2 8
2006 2 3 4 1 2 12
2007 2 8 2 0 2 14
2008 3 9 1 3 2 18
2009 5 3 0 0 3 11
2010 2 10 2 0 0 14
  • AVR
  • CABG
  • CABG + Valve
  • Valve

Bloodless surgery offers patients a safe and effective method for treating patients without the use of whole blood or blood products.

Many of the processes and techniques used in bloodless cardiac surgery were first developed at Pennsylvania Hospital to care for patients whose religious beliefs prevented them from receiving blood products. In recent years, however, religious prohibition has become just one of several considerations prompting bloodless surgery. Emerging research shows that blood transfusions can put patients at higher risk for a variety of postoperative morbidities, including postoperative infection, reoperation for bleeding, stroke, acute renal failure and pneumonia.

Furthermore, recent evidence that blood older than 14 days increases mortality implies that avoiding blood transfusions all together, in patients of otherwise equal risk, is likely to improve outcomes.

Even complex and high risk surgical procedures can be done successfully using bloodless surgical techniques in selected patients, including:

  • Reoperative cardiac surgery in patients with patent internal mammary arteries
  • Aortic root replacement
  • Aortic hemiarch replacement using hypothermic circulatory arrest
  • Multiple procedures (i.e. CABG/valve)
  • Adult congenital cardiac surgery
  • Aortic dissection

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