P058. Are We Far From Bloodless Acute Type A Aortic Dissection Surgery? A Systematic Approach to Reduce Blood Transfusions in Acute Type A Aortic Dissection Surgery
Kexiang Liu
Poster Presenter
Second Hospital of Jilin University
Jilin, Jilin
China
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Dr Liu has been excellent in all kinds of aortic diseases such as acute aortic dissection, coronary artery bypass graft (CABG) in treating coronary artery disease and acute myocardial infarction, modified Maze procedure in ablation of atrial fibrillation, valve replacement and valvuloplasty, minimally invasive cardiac surgery, cardiac trauma, correction of various complex congenital heart diseases and surgical treatment of other common congenital and acquired cardiac diseases. He took the lead in carrying out surgical treatment of aortic diseases in the Northeast of China in 2005, especially in the surgical treatment of acute aortic dissection. Since 2009, professor Kexiang Liu has been devoting lots of efforts to the modifications of treatment of Stanford A aortic dissection, thus creating a novel technique. This novel modified surgical method not only reduces the blood loss, shortens operative time, but also improves the success rate of the surgery, simplifies the complexities of the traditional surgery patterns. The innovations of “Modified Stented-Graft” and “Stented-graft with Artificial Vascular Prothesis ” both obtained national patent. New Progress has been made remarkably since 2016 in the field that more than 50.8% of the aortic dissection surgeries have been performed without blood transfusions.Being the first to carry out independent coronary artery bypass graft (CABG) surgeries in Jilin Province, more than 95% are off-pump and the successful rate reaches more than 99% and the rate of no blood transfusion has reached 93%. Professor Kexiang Liu took the lead in performing hybrid operations containing multiple valve replacement, CABG and surgical ablation of atrial fibrillation. He has been promoting the use of autologous blood recovery technology and almost 73% of the operations are without blood transfusions.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Objective: The aim of this study was to summarize our experience with a systematic approach to reduce blood transfusions in acute type A aortic dissection (ATAAD) surgery.
Methods: From August 2016 to June 2020, 326 patients underwent ATAAD surgery in our center using a systematic approach, which mainly included the following: Liu's aortic root repair technique, Liu's aortic arch inclusion technique with frozen elephant trunk, moderate to mild hypothermia circulatory arrest, and application of centrifugal pump in cardiopulmonary bypass circuit. Patients were divided into two groups according to whether they had blood product transfusion during their hospital stay: transfusion group and bloodless group. Perioperative outcomes were compared between two groups.
Results: 152 patients were included in the transfusion group and 174 patients in the bloodless group; the bloodless rate was 53.37%. Overall in-hospital mortality was 5.21% (17/326), with 3 mortalities (1.72%) in the bloodless group and 14 mortalities (9.21%) in the transfusion group (P=0.0025). The transfusion group had significantly more MODS, sepsis and tracheotomy, and longer intensive care unit stays. Hb levels of patients between the two groups were similar at tested time points.
Conclusions: With the implementation of systematic approach, bloodless ATAAD surgery can be achieved and safely applied in ATAAD patients.
Authors
kexiang liu (1), Cuilin Zhu (2)
Institutions
(1) N/A, Jilin, Jilin, (2) the Second Hospital of Jilin University, China, Jilin Province
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