Abstract
BackgroundJehovah’s Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging. Surgeons must minimize blood and fluid loss within one procedure.Case presentationWe herein describe a 17-year-old male Jehovah’s Witness with bicuspid aortic valve regurgitation and coarctation of the aorta. The procedures were performed in the following order: aortic valve replacement combined with Nick’s aortic root enlargement, right axillary artery–bilateral external iliac artery bypass, and distal arch–descending aorta bypass.ConclusionsAxillary artery–bilateral external iliac artery bypass maintained distal perfusion and reduced the amount of heparin during distal arch–descending aorta bypass surgery.
Highlights
Jehovah’s Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging
Ultrasound examination revealed severe aortic regurgitation caused by a bicuspid valve
Distal perfusion using cardiopulmonary bypass was not required because distal perfusion was maintained by the axillary–iliac artery bypass
Summary
Jehovah’s Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging. Case presentation: We describe a 17-year-old male Jehovah’s Witness with bicuspid aortic valve regurgitation and coarctation of the aorta. We describe a successful staged procedure for bicuspid aortic valve regurgitation and coarctation of the aorta. Case presentation A 17-year-old, 78-kg male Jehovah’s Witness was referred to our center for treatment of bicuspid severe aortic valve regurgitation and coarctation of the aorta. The patient had a history of intermittent claudication and hypertension (blood pressure, 160/65 mmHg) His ankle-brachial index was 0.59 and 0.54 on the right and left, respectively. The patient refused transfusion of whole blood, packed red blood cells, platelets, or plasma regardless of his circumstances He consented to undergo intraoperative cell salvage as long as continuity was maintained with the vascular system
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