Year 2021 Vol. 29 No 2

GENERAL & SPECIAL SURGERY

B.N. GUMENYUK, V.V. POPOV, V.V. LAZORISHINETZ

IRON CORRECTION DURING BLOODLESS SURGERY IN PATIENTS WITH MITRAL HEART DISEASES

Amosov National Institute of Cardio-Vascular Surgery NAMS Ukraine Kiev,
Ukraine

Objective. To study the effectiveness of the preoperative combined correction, using hydroxide of iron (III) and stimulation of hematopoiesis with erythropoietin on the postoperative anemia in patients, undergoning bloodless surgery (mitral valvere placement) in conditions of artificial blood circulation.
Methods. A single-center prospective non-randomized and retrospective study involving patients (n=80) undergoning the operation for mitral valve disease was carried out. There were 54 men (67.5%) and 26 women (32.5%) with an average age of 52.8±4.9 years (M±σ). The patients were divided into three groups. Group A consisted of patients with normal serum iron levels undergoning of the application of blood component preparations. Group B included patients with normal serum iron levels who were undergoning bloodless surgery. In group C the patients with initially low levels of iron in the blood serum, preoperative correction of the saturating dose iron hydroxide and stimulation with erythropoietin were carried out, and bloodless procedure was applied while the operation.
Results. The results of this study show that patients in group A require a sufficiently large volume of donor blood components during surgery. In group B, mitral valve replacement can be performed using bloodless technology without transfusion of donor blood components. Correction of a low preoperative serum iron level in group C increases its preoperative serum iron level by 7.4 times and Hb by 4.4% of the initial haemoglobin values. The level of postoperative anemia in group C (p>0.05) compared with group B (p>0.05) is 8.5% less (p>0.05).
Conclusion. Correction of low preoperative iron levels and stimulation of erythropoiesis in patients with mitral heart disease after mitral valve replacement using a bloodless surgery reduces the postoperative anemia level.

Keywords: mitral heart disease, mitral valve replacement, anemia, iron (III) hydroxide, bloodless technology
p. 146-153 of the original issue
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Address for correspondence:
03038, Ukraine. Kiev,
N.M.Amosov St., 6,
Amosov National Institute of Cardiovasculary
Surgery of NAMS of Ukraine,
Department of Anaesthesiology,
Intensive Care and Mechanical blood circulation tel.+308684859774,
e-mail: gumenyuk2007@ukr.net,
Gumenyuk Bogdan N.
Information about the authors:
Gumenyuk Bogdan N., MD, Senior Research Fellow Department of Anaesthesiology, Intensive care and Blood Circulation. Amosov National Institute of Cardio-Vascular Surgery NAMS Ukraine, Kiev, Ukraine.
https://orcid.org./0000-0002-7954-4769
Popov Vladimir V., MD, Head of the Department of Surgery for Acquired Heart Disease,Amosov National Institute of Cardio-Vascular Surgery NAMS Ukraine, Kiev, Ukraine
https://orcid.org./0000-0002-2851-5589
Lazoryshynetz Vasiliy V., Academician of NAMS of Ukraine, MD, Professor, Amosov National Institute of Cardio-Vascular Surgery NAMS Ukraine, Kiev, Ukraine
https://orcid.org/0000-0002-1748-561X
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