NOT USE OF BLOOD---The

New York Center for Bloodless Cardiac Surgery is the first comprehensive clinical

program of its kind in New York City. The program is an off-shoot of the Bloodless Center first organized at Long Island College Hospital in 1997 and remains the only Center offering a formal program for Bloodless Cardiac Surgery in the city. Our physicians have led the way in research that has advanced bloodless medicine and surgery. Our innovative center has attracted patients not only from the metropolitan area, but from all over the world; in fact, many of our patients come to us after other institutions were unable or unwilling to treat them without the use of blood transfusions. Increasing numbers of patients are choosing to avoid blood transfusions during their care and treatment. We embrace this philosophy of care and are committed to serving the needs of those who do not want blood transfusions We treat all types of patients at the New York Center Bloodless Surgery. Some refuse any and all blood and blood products. Others come because they would like to minimize or eliminate the use of blood products. In either case, patients are identified by a special wristband and chart labeling, and their written wishes are put in their chart. The care is carefully coordinated by the staff of the Center, so patients are sure to receive comprehensive, expert care every step of the way. Blood transfusions may suppress the immune system. A suppressed immune system can lead to an increased risk of diseases or infection. Despite improvements in the screening process of the blood supply, a small risk for the transmission of infection via blood and blood products still exists. Since the American Red Cross has begun screening blood for the HIV virus there has not been a documented transmission of the virus through a transfusion of blood or blood products. However, there still is a chance, albeit very, very small, of contracting Hepatitis, an infection which is usually but not always self-limiting. The recovery time after surgery may be shorter after a bloodless procedure, frequently due to fewer postoperative complications. Our Technology and Techniques for Bloodless Health Care Pharmaceuticals: Such as erythropoietin, a synthetic hormone used to stimulate bone marrow to produce more red blood cells. Other drugs can stimulate the creation of white blood cells and platelets. There are also medications to reduce blood loss during surgery or help to reduce acute bleeding. Lab Technology: Allows less blood to be drawn for testing Biological Products that Stop Bleeding: Such as collagen and cellulose woven pads that stop bleeding by direct application. Fibrin glues and sealants that cover large areas of bleeding tissue are also used. Perioperative Blood Salvage: Including the Cell Saver that recovers and recycles blood that is lost during surgery. Shed blood is collected and the red blood cells are concentrated and washed prior to reinfusion. Postoperative blood salvage can also minimize the total blood loss from surgical procedures. Intraoperative Hemodilution: In which blood is drawn from a patient in the operating room just before surgery. The patient is immediately given intravenous fluids to compensate for the amount of blood removed. The blood drawn from the patient is reinfused during or at the end of the surgery. This can result in a lower total blood loss and may help with clotting at the end of the surgery. Preoperative Autologous Blood Donation: an option for selected patients who wish to donate their own blood prior to certain elective surgeries. However, this is rarely used in most cardiac procedures. Special Techniques: At St. Luke's - Roosevelt Hospital, we have developed a number of special techniques to minimize hemodilution by the heart-lung machine, from retrograde autologous priming of the pump to vacuum assisted venous drainage to specially designed extra small volume bypass circuits. The amount of fluid necessary to prime the heart-lung machine is dramatically reduced and unnecessary hemodilution is avoided. This procedure is somewhat different from planned hemodilution as described above.