Safety And Efficacy Of A Simple Cardiotomy Suction System As A Blood Salvage Procedure During Off-pump Coronary Artery Bypass Surgery
Ryoji Kinoshita, Susumu Manabe, Daiki Hirayama, Norihisa Yuge, Masahiro Oonuki, Kazunobu Hirooka.
Tsuchiura Kyodo General Hospital, Tsuchiura city, Ibaraki, Japan.
Objective:The ideal blood salvaging strategies for off-pump coronary artery bypass graft procedures have not been determined. We developed a new blood salvaging system that uses a cardiotomy suction. The purpose of this study was to examine the efficacy of this novel method. Methods:This was a retrospective study involving 100 consecutive patients undergoing off-pump coronary artery bypass grafting during from June 2015 to July 2018 in our hospital. In 50 patients, a simple cardiotomy suction system was used (cardiotomy suction group). These individuals were compared with 50 historical cohorts who were treating with the conventional cell saver system (cell saver group).Results:There was no significant difference in the patient's background. There was no in-hospital mortality in either group. The patients who were received a blood transfusion were significantly fewer in the cardiotomy suction group (cardiotomy: 22%; 11/50 vs. cell saver: 44%; 22/50, p = 0.03). The cardiotomy suction group tended to be received fewer transfused RBC (cardiotomy: 0.85 ±2.1 units vs.cell saver: 1.44±2.4 units, p = 0.18). The post-operative serum total protein and albumin levels were significantly higher in the cardiotomy group. As there was concern about kidney injury due to crushed erythrocyte because it had not been removed in thecardiotomy suction group, there was no significant difference about the rate of change in serum creatinine level and the postoperative amount of urine.Conclusions:Our newly-developed simple cardiotomy suction system, when compared with the conventional cell saver system, produced similar clinical results and attenuated postoperative hemodilution. Our system may emerge as a preferable alternative for blood salvage during off-pump coronary artery bypass grafting. 
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