29 September 2020
Sickle cell and cardiac operations
Published online 24 March 2010
Sickle-cell anaemia and sickle-cell trait come about as a result of a recessively inherited genetic disorder. They are characterized by haemoglobin adopting a sickle shape, thereby impairing its ability to carry oxygen. Depending on the severity of the case, this can lead to complications such as anaemia and vasoocclusion. Documentation of the risks of cardiac surgery for patients with sickle-cell haemoglobinopathy is scarce.
Researchers from the King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia, conducted a retrospective study of 47 open-heart surgeries conducted in their centre between 1995 and 2006 for patients with some form of sickle-cell syndrome.
The average age of the patients was 20 years. The study found that none of the patients developed sickling crisis or acidosis; however, eight developed complications ranging from stroke to renal failure. The study found that 66% of the patients had no cardiac symptoms, indicating that the operations had an acceptable outcome for those with sickle-cell syndrome.
Researchers suggest that exchange blood transfusion before the operation is beneficial to increase the oxygen supply during the surgery. Decreasing the load of sickle-cell haemoglobin in the blood both before and during the operation increases the rate of success. They also strongly recommend sedation and warm-air blankets throughout the operation, as stress and hypothermia are major factors leading to sickling crisis.