Managing bleeding patients in heart transplantation and high-risk cardiac surgery is a constant challenge. Considerable experience has been accumulated over the years in transfusion support and perioperative therapies in high risk cardiac surgery. Other tertiary medical centers in the US and Canada also perform such increasingly complex high risk surgeries associated with predictable and unpredictable bleeding that demand close transfusion support, coagulation testing, and decisions on perioperative therapies.
How best to manage clinical bleeding through targeted blood product utilization remains controversial. Transfusion algorithms can be useful, but applied in a dynamic surgical setting, the time it takes to obtain coagulation results, order appropriate products and administer them may be too long, forcing clinicians to rely on intuition and empiric treatment. Perioperative management complexities include the increased use of mechanical perfusion devices that require anticoagulation, increased application of antiplatelet agents, newer classes of anticoagulants, and point of care testing.
One speaker will be a transfusion medicine specialist addressing specific issues in blood product ordering and utilization in heart transplantation and high-risk cardiac surgery; the second speaker (an anesthesiologist) will discuss challenges in the operating room in mediating decisions about laboratory test results and ordering of blood products and decision about perioperative therapies.
All relevant financial relationships have been mitigated.
Examine the major decisional challenges in managing bleeding in the operating room in heart transplantation and high risk cardiac surgery.
Debate controversies in blood product utilization in heart transplantation and high risk cardiac surgery
Discuss challenges in perioperative therapies and coagulation testing in cardiac surgery.