Methods: The study included 19 patients (3 females, 16 males; mean age 54±16 years; range 21 to 76 years) with aortic aneurysms, whose operations were performed using the Fresenius cell saver system capable of continuous autotransfusion. Seventeen patients had descending thoracic aortic aneurysms either associated with dissection (n=8) or rupture (n=5). Two patients had ruptured abdominal aortic aneurysms. Operations were performed using the simple cross-clamp technique. Cerebrospinal fluid drainage was also performed for thoracic aneurysms. The relationship between the amount of transfusion and mortality/hemorrhage was analyzed.

Results: The mean aspirated blood volume by the cell saver device was 2,311±543 ml, and the mean autotransfused blood volume was 748±163 ml. The mean crossclamp time was 44±5 minutes. The mean postoperative drainage was 1,106±726 ml and the patients received a mean of 4.2 units and 5.3 units of packed red cell or fresh frozen plasma, respectively. Two patients with descending thoracic aortic aneurysms underwent revision due to early postoperative bleeding. No neurological complications occurred. There were five early postoperative deaths, one due to disseminated intravascular coagulation, another due to cardiac failure, and three due to multiorgan failure. No significant difference was found between the pre- and postoperative hematologic parameters (p>0.05). Patients who underwent revision due to postoperative hemorrhage and those who did not have postoperative hemorrhage showed no significant difference with respect to the amount of autotransfused blood. Nor did the patients who died and survived postoperatively (p>0.05).

Conclusion: Preservation and subsequent utilization of the patient's blood via the cell saver system reduces the need for allogenic blood transfusion and reduces associated risks in patients who often require a substantial amount of transfusion during elective or urgent aortic aneurysm operations.