Cell saver efficacy for routine coronary artery bypass surgery

A retrospective study was conducted to determine the effect of intraoperative Haemonetics Cell Saver (HCS) usage on postoperative homologous blood product requirements in CABG patients. From 1 January to 31 December 1993, 516 patients without renal disease or postoperative surgical or gastrointestinal haemorrhage had elective, first-time CABG surgery. The HCS was utilized in 435 of these patients (Group CS) and in 81 patients the HCS was excluded (Group NCS). Preoperative patient variables were similar in the group. We evaluated the HCS effect on blood product transfusion by comparing -x units of red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PLTS) transfused per patient between groups CS and NCS. There were no differences in the -x units of RBC (1.9 +/- 2.7 CS vs. 1.8 +/- 1.5 NCS) or in the RBC transfusion rate (48% CS vs 50% NCS). There were also no significant differences between the groups in -x units of FFP (0.9 +/- 0.8 CS vs 0.4 +/- 0.9 NCS) or PLTS (0.7 +/- 3.1 CS vs 0.4 +/- 2.5 NCS), or in the percentage of patients receiving these products (12% CS vs 8% NCS). These data provide no evidence that the use of the HCS decreases the amount of homologous blood bank products required postoperatively in patients having routine first-time CABG surgery. The current era of aggressive blood conservation may have limited the role of the HCS in routine CABG surgery.

Latissimus dorsi cardiomyoplasty: radiographic findings

Left latissimus dorsi muscle cardiomyoplasty is a surgical procedure in which the muscle is mobilized as a pedicled flap, moved into the left pleural and mediastinal cavities, and used for surgical repair and/or mechanical augmentation of a failing left ventricle. Chest radiographs in four patients who had undergone this procedure were evaluated. In all four patients, there was bandlike or diffuse increase in density in the left midhemithorax with loss of the left heart border. These findings, which could be misinterpreted as lung disease, represent the transposed muscle flap. CT showed the exact anatomic position of the flap in relation to the intrathoracic structures. Familiarity with the postoperative radiographic appearance of this type of myoplasty is important to avoid misinterpretation.