Bloodless Cardiac Surgery

The Stanford Center for Bloodless Cardiac Surgery provides lifesaving options for patients who cannot or choose not to receive blood transfusions. This comprehensive center brings together a multidisciplinary team of experts, including cardiothoracic surgeons, anesthesiologists, hematologists, and perfusionists, to perform most complex cardiac procedures without the use of blood products.

Comprehensive Care in Bloodless Cardiac Surgery

Understanding Bloodless Cardiac Surgery

Bloodless surgery, also known as transfusion-free surgery, is a technique that uses no blood products or transfusions during surgery. Rather, a patient’s own blood is preserved with cutting-edge surgical techniques and technology. Patients may decline blood or blood products for religious, personal, or medical reasons. Research shows that bloodless surgery can have several benefits for patients, including a possible shorter hospital stay and a quicker recovery. Not all cardiac surgeries can be performed bloodless, but many can.

Preoperative Process

Before surgery, the team will order comprehensive blood tests to determine whether a patient would benefit from preoperative optimization treatments to boost blood reserves. The required blood sample is small and collected in a smaller tube than is typically used for routine laboratory testing.

Results are reviewed collaboratively by the cardiac surgery, anesthesia, and hematology teams to develop a personalized plan tailored to each patient.

If indicated, patients may be referred to the Anemia Clinic prior to surgery for further evaluation and treatment planning. The CT Surgery team will notify patients directly if this is needed. While timelines are patient-specific, most therapies require approximately 4–6 weeks to achieve optimal effect before surgery.

Common Preoperative Optimization Strategies

Erythropoietin (EPO) therapy – Stimulates red blood cell production; typically requires several weeks for full effect.
Iron infusion therapy – Replenishes iron stores to support red blood cell formation; often administered through the Anemia Clinic when indicated.
Vitamin B12 supplementation – Corrects deficiencies that impair red blood cell production.
Folate supplementation – Supports healthy red blood cell development.

Blood Product Planning

Comprehensive review of blood and blood-derived products – The team conducts detailed, individualized discussions to ensure patients understand all available options and can make informed decisions about which products they are willing to accept or decline.

Intraoperative Process

During surgery, we utilize a multifaceted approach to conserve blood. Our bloodless surgery team:

Ensure adequate hemostasis and minimal blood loss
Use a cell saver to process the patient’s own blood
Operate a cardiopulmonary bypass machine
Connect additional lines and tubing to ensure the circuit remains unbroken for individuals who prefer their blood remains in a continuous circuit

Postoperative Care

The Stanford Advantage

At Stanford Medicine, we employ the latest blood management techniques and transfusion alternatives to maximize patient safety. Our team uses all available options and applies careful, advanced techniques to minimize potential blood loss during surgery.

Learn more at Stanford Health Care.