Objectives

We investigated the effects of the combined use of preoperatively separated autologous red blood cells, plasma, and fibrin sealant on reducing allogeneic blood transfusion during valve-sparing root replacement using the aortic root remodeling technique, by comparison with transfusion of refrigerated, predeposited autologous whole blood.

Methods

Thirty-nine patients underwent elective, initial valve-sparing root replacement using the aortic root remodeling technique by a single surgeon between April 2018 and December 2023. Of these, 9 patients in Group A predeposited autologous whole blood until September 2019 and 12 patients in Group B predeposited separated autologous red blood cells, plasma, and fibrin sealant after October 2019. The intraoperative allogeneic blood transfusion avoidance rate was compared between Groups A and B.

Results

The allogeneic blood transfusion avoidance rate in Group A was 66.7% for red blood cells, 55.6% for plasma, 55.6% for platelets, and 55.6% for all components combined. In Group B, the avoidance rate was 100% for each component, significantly higher than in Group A for plasma, platelets, and all components combined (all P = 0.021). Postoperative hemoglobin level was significantly higher and amount of chest tube drainage during the first 12 postoperative hours was lower in Group B.

Conclusions

This before-and-after study suggested that the combined use of preoperatively separated autologous red blood cells and plasma and fibrin sealant can be an effective blood management strategy in patients undergoing valve-sparing root replacement using the aortic root remodeling technique, reducing intraoperative allogeneic blood transfusion compared with predeposited autologous whole blood transfusion.