Cardiac surgeries, such as Coronary Artery Bypass Graft (CABG) and Aortic Valve Replacement (AVR), are lifesaving procedures that address ischemic heart disease and valvular disorders, improving and transforming millions of lives globally. Despite their success, postoperative blood loss remains a persistent yet under-addressed challenge, contributing to complications such as anaemia, infection, prolonged ICU stays, and increased healthcare costs. Current blood management protocols, including those at Cork University Hospital, rely on generalised guidelines that inadequately account for the distinct surgical complexities and patient-specific factors associated with CABG and AVR. This research aims to bridge this critical gap through a stratified comparison of blood loss patterns in CABG versus AVR patients.
This retrospective observational study will analyse 500 patients (250 CABG and 250 AVR) treated at Cork University Hospital over the last five years. To ensure baseline comparability, all patients included will have been preoperatively managed with aspirin monotherapy. Blood loss will be quantified using a validated methodology that integrates chest drain output, haemoglobin mass loss, and transfusion data. Stratification will consider key variables such as cardiopulmonary bypass time, EuroSCORE, BMI, and valve type. Subgroup analyses will identify high-risk populations, and Logistic regression models will validate predictors of significant blood loss while adjusting for potential confounding factors
By addressing procedure-specific differences in CABG and AVR surgeries, this study aims to develop evidence-based guidelines tailored to each procedure and patient. The findings are expected to inform targeted perioperative strategies, reducing transfusion rates, improving surgical outcomes, and enhancing healthcare resource efficiency. Furthermore, this project seeks to establish a new standard of care within the HSE, offering a scalable framework for tackling procedure-specific challenges across cardiac surgeries. These insights have the potential to drive transformative improvements in patient outcomes, optimise resource utilisation, and advance standards of cardiac care within Ireland and beyond.