Matsumura R, Yoshino T, Kobayashi T, Fudemoto Y, Sawada Y
Kokyu To Junkan. 1989 Jun;37(6):687-90.
An aorto-coronary bypass grafting was performed in a 50 year-old man, a Jehovah's Witness, suffering from effort angina pectoris. Preoperatively, he was underwent PTCA for LAD occlusion, which failed. Single aorto-coronary bypass grafting using IMA was performed under the extracorporeal circulation primed with Ringer's Lactate and albumin. Moderate hypothermia with core temperature of 31.5 degrees C was used, and minimal level of the hematocrit was 18% during the perfusion. At the start of the operation, 800 ml of blood were withdrawn from the jugular vein to the blood bag which connected to a peripheral venous line uninterruptedly. During the operation, the autologous blood was continuously transfused very slowly and most of the autologous blood was transfused after the termination of extracorporeal circulation. The blood in the extracorporeal circuit was hemoconcentrated with ECUM (extracorporeal ultrafiltration method) from hematocrit level 22% to 35% and transfused. The postoperative course was uneventful. At the time of discharge from hospital on the 42nd postoperative day the hemoglobin level was 13.1 g/dl and hematocrit level was 42%.
对一名50岁患有劳力性心绞痛的耶和华见证会男性患者进行了主动脉冠状动脉搭桥术。术前，他因左前降支闭塞接受了经皮冠状动脉腔内血管成形术（PTCA），但手术失败。在使用乳酸林格氏液和白蛋白预充的体外循环下，采用内乳动脉进行了单根主动脉冠状动脉搭桥术。采用了中度低温，核心温度为31.5摄氏度，灌注期间血细胞比容的最低水平为18%。手术开始时，从颈静脉抽取800毫升血液至与外周静脉管路相连的血袋中。手术过程中，自体血以非常缓慢的速度持续输注，且大部分自体血在体外循环结束后输注。体外循环回路中的血液通过体外超滤法（ECUM）从血细胞比容水平22%浓缩至35%后进行输注。术后病程顺利。术后第42天出院时，血红蛋白水平为13.1克/分升，血细胞比容水平为42%。
