Can patients with left main stenosis undergo autologous blood donation prior to elective coronary artery bypass surgery?

Purpose: To determine die safety and efficacy of autologous blood donation in patients with stable angina and left main stenosis needing elective coronary artery bypass surgery (CABG). Methods: Between May 1993 and May 1996, forty two patients with stable angina and left main stenosis underwent autologous blood donation before elective coronary artery bypass surgery. The patients were predominantly male (40 out of 42) and the mean age was 60±8 years. Ejection fraction was >35% in 39 (93%) of the patients. Results: The patients donated an average of 3.2±0.7 units of whole blood (fractionated into packed cells and fresh frozen plasma) over a four week period. Four patients (9.5%) had worsening of angina resulting in cessation of one or more blood donations but not admission to hospital. CABC was performed 71±28 days after acceptance for surgery. Homologous blood transfusion averaged 0.6 units per patient and was totally avoided in 76% of the patients. Hemoglobin before and after donations were 145±11 and 126±12 grams/L respectively. The hemoglobin at hospital discharge was 107±11 grams/L. There were no operative deaths. Conclusions: Autologous blood donation is a safe and effective blood conservation strategy for selected patients with left main disease. Clinical Implications: Patients with left main stenosis requiring elective surgery should be considered candidates for autologous blood donation.