Repair of acute type A aortic dissection without the use of blood products

Ascending aorta replacement for acute aortic dissection repair was carried out in a 29-year-old man without the use of blood or blood products. Intraoperative blood loss was minimized with the use of biological glues and red cell salvage. Erythropoietic agents were started before surgery and continued during and after operative repair. Postoperatively, oxygen balance was maintained despite very low hemoglobin levels by increasing the cardiac output to compensate for the low oxygen-carrying capacity, thus maximizing oxygen delivery. Only essential laboratory determinations were carried out, which reduced additional blood loss. Repair was successful, and the patient was discharged from the hospital despite a delay in diagnosis and definitive surgical repair.