Yoshinobu Hattori

Between January 1986 and July 1989, cardiopulmonary bypass without blood priming was attempted in 55 patients, During the course of hospitalization no blood transfusion was used in five of seven patients with the body weight under 20kg, in nine of 11 patients weighing between 20 and 30kg, and in 30 out of 37 patients weighing more than 30kg. With proper case selection, open heart surgery without blood transfusion was possible even in patients weighing less than 20kg.

Patients who required permanent pacemaker implantation following open heart surgery were studied. There were 11 such patients among our cardiac surgery patients during the period from April 1975 to August 1987. Seven of the eleven patients were valvular heart disease patients, mostly of the mitral valve, and two were older ASD patients. Six patients required PM within one month of the operation and a causal relationship could not be denied between surgery and the need for PM implantation, the rest of the cases required PM beyond four months of the operation. Although many patients were on anticoagulation therapy and had had tricuspid annuloplasty, the pervenous PM implantation could be safely performed in all patients. Especially in valve replacement patients (except in trisuspid valve replacement) early PM implantation avoids prolonged period of external pacing and will be safer from the standpoint of infection, and in many cases earlier PM implantation will be beneficial for smoother restoration of functional status of the patients.

Patients who required permanent pacemaker implantation following open heart surgery were studied. There were 11 such patients among our cardiac surgery patients during the period from April 1975 to August 1987. Seven of the eleven patients were valvular heart disease patients, mostly of the mitral valve, and two were older ASD patients. Six patients required PM within one month of the operation and a causal relationship could not be denied between surgery and the need for PM implantation, the rest of the cases required PM beyond four months of the operation. Although many patients were on anticoagulation therapy and had had tricuspid annuloplasty, the pervenous PM implantation could be safely performed in all patients. Especially in valve replacement patients (except in trisuspid valve replacement) early PM implantation avoids prolonged period of external pacing and will be safer from the standpoint of infection, and in many cases earlier PM implantation will be beneficial for smoother restoration of functional status of the patients.