JACC. Case reports · 2025
Bloodless Third Reoperative Multivalvular, Aortic, and Double-Chamber Right Ventricular Surgery in a Jehovah's Witness Patient.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Leib Philip, Umana-Pizano Juan B, Putnam Jonathan, Mehta Anand, Angelini Dana, Fuchs Margaret, Ghobrial Joanna, Roselli Eric E
Аннотация
BACKGROUND: Jehovah's Witness patients present unique challenges in cardiac surgery given their refusal of blood transfusion. This complexity is amplified in reoperative and congenital cases.
CASE SUMMARY: A 60-year-old, 45-kg Jehovah's Witness woman with complex congenital heart disease and prior cardiac interventions underwent successful third-time sternotomy for mechanical aortic valve replacement, ascending aortic replacement, patent ductus arteriosus ligation, and double-chamber right ventricle repair using a bloodless strategy. A multidisciplinary approach was used to optimize her physiology preoperatively. Intraoperative management included cell salvage, autologous transfusion, and hemostatic agents. She was discharged on day 24 with preserved cardiac function.
DISCUSSION: This case highlights the feasibility of high-risk, bloodless congenital reoperations through careful perioperative planning, preoperative imaging, and adherence to institutional blood conservation protocols.
TAKE-HOME MESSAGES: Multidisciplinary planning and preoperative imaging are important for procedural preparation in high-risk bloodless cardiac surgery. Institutional protocols and experience are keys to success in complex bloodless reoperations.
CASE SUMMARY: A 60-year-old, 45-kg Jehovah's Witness woman with complex congenital heart disease and prior cardiac interventions underwent successful third-time sternotomy for mechanical aortic valve replacement, ascending aortic replacement, patent ductus arteriosus ligation, and double-chamber right ventricle repair using a bloodless strategy. A multidisciplinary approach was used to optimize her physiology preoperatively. Intraoperative management included cell salvage, autologous transfusion, and hemostatic agents. She was discharged on day 24 with preserved cardiac function.
DISCUSSION: This case highlights the feasibility of high-risk, bloodless congenital reoperations through careful perioperative planning, preoperative imaging, and adherence to institutional blood conservation protocols.
TAKE-HOME MESSAGES: Multidisciplinary planning and preoperative imaging are important for procedural preparation in high-risk bloodless cardiac surgery. Institutional protocols and experience are keys to success in complex bloodless reoperations.