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Transfusion-Free Cardiothoracic Surgery

USC Cardiothoracic Surgeons Provide Complex Heart Surgeries, Transfusion-Free
From Transfusion-Free News, A Newsletter of the Medicine and Surgery Program
of Keck Hospital of USC and USC/Norris Cancer Hospital

Heart transplants without the need for blood transfusions. Mitral valve repairs without using major blood components. As challenging as these sound, cardiothoracic surgeons at Keck Hospital of USC have done what many consider complex heart surgery, transfusion-free.

Indeed, members of the USC cardiothoracic surgery team have been some of the leaders in many aspects of cardiovascular disease treatment for more than 10 years. These surgeons, along with their clinical, research and administrative staffs, offer comprehensive, advanced therapy for many diseases of the chest including adult cardiac surgery, minimally invasive cardiac surgery, endoscopic vein harvest, adult thoracic surgery, video-assisted thoracic surgery, pediatric cardiac and thoracic surgery, and heart and lung transplantation.

Since Vaughn A. Starnes, M.D., professor and chair of the Department of Cardiothoracic Surgery at the Keck School of Medicine of USC, joined Keck Hospital of USC in 1992, the clinical programs in cardiac surgery, thoracic surgery and transplantation surgery have exploded. Nowhere is this more dramatically illustrated than the transplantation program, which includes adult and pediatric heart, lung, and heart-lung procedures--including pioneering donor-lobar lung transplants.

A Clear Vision

Dr. Starnes' mission is to the point: "To further advance the treatment of patients with cardiothoracic diseases. And we do this on three levels: offering patients the latest clinical techniques, participating in advanced clinical research and conducting innovative basic research projects."

USC cardiothoracic surgeons offer a broad range of care. Some of their areas of expertise include:

  • Adult and Pediatric Heart, Lung and Heart-Lung Transplantation
    Dr. Starnes has pioneered advances in heart, lung and heart-lung transplantation, including living donor lobar lung transplantation.

  • Minimally Invasive Surgical Techniques
    This approach eliminates the need for a sternotomy. Some procedures are performed on the beating heart, minimizing the use of the heart-lung machine. USC cardiothoracic surgeons are among the leaders in performing minimally invasive direct coronary artery bypass, minimally invasive valve procedures, port access technology for a variety of minimally invasive procedures including multi-vessel disease, and video-assisted thoracic surgery that avoids the need for an open incision.

  • Pediatric Cardiothoracic Surgeries
    In addition to performing pediatric heart and lung transplantation, USC cardiothoracic surgeons conduct pulmonary valve translocation (the Ross procedure), and the Norwood procedure, which corrects hypoplastic left heart syndrome. The surgeons also specialize in congenital cardiac surgery, including the use of cyropreserved homograft tissue to repair the heart, and repair of complex congenital anomalies of the trachea that can cause narrowing.

  • Cardiac Surgeries
    USC cardiothoracic surgeons perform a broad range of valve surgeries, including adult aortic valve disease and mitral valve repairs. Coronary bypass surgeries are also performed through a variety of approaches.

  • Ventricular Assist Devices
    USC is one of the investigational sites of a modern generation of left ventricular assist devices. The surgeons use these devices as a bridge to transplantation for patients with end-stage heart disease.

  • Transfusion-Free Expertise
    A focus for Dr. Starnes is transfusion-free medicine. He first gained experience in transfusion-free techniques during his training at Stanford University. In the past few years, he has helped make bloodless surgery a "real emphasis" at Keck Hospital of USC.

He says success in transfusion-free cardiothoracic surgery involves being a "stickler for details." Dr. Starnes and his colleagues understand and are experts in surgical precision during each procedure they perform. In addition, "it is important that a transfusion-free program makes a real commitment to perform these complex surgeries without blood products--and every member of our team has that commitment."

Interestingly, Dr. Starnes' commitment to transfusion-free medicine carries over to all of his patients, and he and his team try to do as many of their surgeries as possible without the use of blood products. "There is no need to expose patients to potential infection or inflammatory reactions that may be associated with transfusions," says Dr. Starnes. "While there is no doubt that transfusion-free medicine is more challenging, it may be also better medicine for the patient."


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