Bloodless Cardiac Surgeon


Chief of Cardiac Surgery – Hospital Teknon

Languages: English, French, Spanish

Dr. Ruyra - Bloodless Cardiac Surgeon

Dr. Ruyra – Cardiac Surgeon

Dr. Xavier Ruyra-Baliarda is a specialist in Bloodless Cardiac Surgery and leads a team of professionals whose main goal is to provide patients with the entire range of possibilities that exist in modern heart surgery.

Dr. Ruyra-Baliarda specializes in valve repair, thereby avoiding the need for replacement using artificial prosthetics as used in the complex Ross technique and cardiac cavity reconstruction surgery. Over the years numerous surgical techniques have been developed to minimize the aggressiveness of the procedure on the heart and the whole body. These Smart cardiac surgery programs include beating heart coronary surgery, minimally invasive cardiac surgery and bloodless cardiac surgery.

The facilities where Dr. Ruyra develops the “Smart Cardiac Surgery Program” have a comprehensive structure covering the study, diagnosis and full treatment of cardiovascular illnesses. It is made up of a multidisciplinary team of Cardiologists, Heart Surgeons, Vascular Surgeons, specialists in Cardiac Imaging, Haemodynamicists, Electrophysiologists and experts in Cardiovascular Rehabilitation.

Bloodless Cardiac Surgery or Bloodless Heart Surgery is transfusion free cardiac surgery, where the patient’s wishes are respected based not only on religious beliefs but also with the intention of trying to avoid the potential risks associated with blood transfusions, such as infections, complications and mortality.
Any type of heart surgery can be performed without external blood, including complex operations, and this depends solely upon the patient’s state of health, which is evaluated prior to surgery in order to determine if surgery can take place.

If necessary, treatment to address the patient’s health are carried out in order to be able to perform this type of surgery.

Under the direction of Dr. Ruyra, an expert Cardiac Surgeon, our bloodless cardiac surgery team has become an international benchmark, treating patients from all over the world. Mortality under Dr. Ruyra’s expert hands in bloodless cardiac surgery is 1.5% versus mortality of 11.8% overall in Europe, reported by The European System for Cardiac Operative Risk Evaluation (

This shows that we provide first class results of the highest quality.

Why Bloodless Medicine and Surgery?

Bloodless medicine and surgery is possible, even in specialties such as cardiac surgery, which are potentially very bloody. Issues to consider regarding blood transfusions:

  • Blood is a scarce commodity. There is more demand than supply.
  • Blood transfusions are a therapeutic procedure that is not exempt from complications.
  • The use of hemoderivatives has a high cost.
  • Additionally there are many countries where the blood used is not safe.

The transfusion must always be viewed with caution because it involves a number of general risks:

  • Infection. Although blood is very safe in developed countries, there is always danger of infection.
  • Lung problems.
  • Idiosyncratic reactions.
  • May cause immunomodulation. It produces a metabolic and immunological overexertion.
  • It can reduce immunocompetence. Reducing the body’s immune system i.e. the defense capacity of our body which in turn can:
    • Activate viral infection
    • Increase postoperative infections
    • Cause cancer recurrences

There is sufficient evidence and studies which show that the results are better in patients who have undergone heart surgery if they have not needed hemoderivatives.

The latest guidelines of the Associations of Thoracic Surgeons and Specialist Anesthetists in Cardiac Surgery make it clear that we must try not to transfuse patients who undergo heart surgery. It has been recognized that a patient who has received a transfusion has a shorter life span, and even long-term survival is directly related to the number of concentrates the patient receives. In every case, this patient has greater morbidity: renal failure, prolonged intubation, major infections, cardiac morbidity, low cardiac output, neurological morbidity.

There is astounding and universal evidence to show that a patient who receives a transfusion in cardiac surgery is more likely to have higher mortality in the short, medium and long term than someone who does not undergo a transfusion, and there is even a study that claims it can affect the patient’s life in the long term.

How is Bloodless Surgery possible?

Many pre-operative and intra-operative measures are used, but the most significant is the use of Blood or Cell recuperators like; Cell-saver, Hemobag and Modified Ultrafiltration.

Cell Saver Bloodless Surgery

Cell Saver Recuperator

Cell Saver Bloodless Surgery

Hemobag Blood Refusion Bag

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Bloodless Surgery Testimonials

Malcom Debbage. Norfolk (UK) – Mitral Valve Surgery by Dr. Ruyra

“Malcolm became very ill in October 2012 and the tests results showed and incompetent mitral valve. We were very worried so we wanted the best cardiac surgeon and we were recommended Bloodless Cardiac Surgeon Dr. RUYRA. The operation and the aftercare were superb. I am now able to do all my sports and live a normal life. Thank you very much once again, for your professionalism, dedication and caring showed toward my wife and I during this stressful time.”

Marcos Santana – Bloodless Dissecting Aortic Aneurysm Repair – Dr. Ruyra

“Hello, my name is Marcos Santana. I am 32 years old and I am a Jehovah’s Witness. In 2010 I was diagnosed with a dissecting aortic aneurysm. Due to my strong religious convictions which are based on biblical teachings, I was not willing to receive blood transfusions and therefore I could find no surgeon who would perform bloodless cardiac surgery on me. With my existing alternatives in mind, I continued my search until I discovered Bloodless Cardiac Surgeon Dr. RUYRA and his team who indeed were willing and able to carry out the surgery. In 2013 they operated on me, and did an excellent job of replacing my damaged Aorta with a synthetic tube and thus they were able to resolve my problem. I’m deeply grateful for the work that Dr. Ruyra and his team carried out and I would like to thank him on me and all of my family’s behalf for respecting my personal beliefs, his confidence, his friendliness as well as his professionalism.”

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