The Ross operation in a Jehovah’s Witness: a paradigm for heart surgery in children without transfusion

• Published in: The Annals of thoracic surgery Vol. 69; no. 3; pp. 935 - 937
• Main Authors: Miyaji, Kagami, Hannan, Robert L, Ojito, Jorge W, White, Jeffrey A, Burke, Redmond P
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2000; Elsevier Science
• Subjects: Aortic Valve Insufficiency - surgery; Biological and medical sciences; Blood Transfusion, Autologous; Cardiac Surgical Procedures - methods; Child, Preschool; Christianity; Humans; Male; Medical sciences; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Human; Treatment efficiency; Conservation; Cardiovascular disease; Aortic regurgitation; Blood; Case study; Treatment; Cardiac valvular disease; Surgery; Technique; Jehovah witness; Child; Aortic valve
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(99)01405-8

A 3-year-old 18 kg male child of the Jehovah’s Witness faith presented with severe aortic regurgitation. A successful Ross procedure was performed using a pulmonary autograft, without the use of blood or blood product transfusion. Blood conservation strategy included: (1) preoperative treatment with recombinant human erythropoietin; (2) intraoperative strategies, including technical modifications to the Ross procedure, and the prophylactic use of fibrin glue; (3) utilization of a heparin-bonded cardiopulmonary bypass circuit and assisted venous drainage; and 4) the use of prebypass phlebotomy, cell-saving device and autotransfusion. The patient was discharged home on postoperative day 7 with a hemoglobin level of 11.9.