Results of open heart surgery in Jehovah's Witnesses patients

• Published in: Journal of cardiovascular surgery Vol. 50; no. 2; pp. 247 - 250
• Main Authors: Juraszek, A, Dziodzio, T, Roedler, S, Kral, A, Hutschala, D, Wolner, E, Grimm, M, Czerny, M
• Format: Journal Article
• Language: English
• Published: Italy Edizioni Minerva Medica 01-04-2009
• Subjects: Aged; Anemia - blood; Anemia - etiology; Blood Loss, Surgical - prevention & control; Blood Transfusion; Blood Vessel Prosthesis Implantation - adverse effects; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Coronary Artery Bypass - adverse effects; Female; Heart Valve Prosthesis Implantation - adverse effects; Hematocrit; Humans; Jehovah's Witnesses; Male; Middle Aged; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - prevention & control; Religion and Medicine; Retrospective Studies; Treatment Outcome; Treatment Refusal
• ISSN: 0021-9509; 1827-191X

The aim of this paper was to evaluate the results in patients from the religious community of Jehovah's Witnesses (JW) undergoing open heart surgery.
Between January 1998 and November 2007, 35 patients with a religious background of JW church underwent open heart surgery at the Department of Cardiothoracic Surgery, Medical University of Vienna (Austria). Eighteen patients underwent coronary artery bypass graft (CABG), 11 patients underwent valve surgery and 5 patients underwent combined procedures. One patient underwent isolated ascending aortic replacement. Five patients undergoing CABG were operated without cardiopulmonary bypass (CBP).
Mean baseline hematocrit serum levels were 35.8+/-6.3%. The mean decrease of hematocrit serum levels was 20.0+/-21.1% after surgery. The mean decrease of hematocrit serum levels in patients undergoing CABG without CPB was 12.5+/-5.4% and 12.0+/-20.0% in patients after isolated valve replacement. One patient died during the operation. Four patients died in the postoperative period due to anemia. During follow-up, being 34.6+/-34.8 months to date, no cardiovascular related adverse event has been observed.
The decrease of hematocrit serum levels is significantly characterizing the postoperative period of open heart surgery in JW. In patients undergoing CABG without CPB and in patients undergoing isolated valve replacement, decrease of hematocrit serum levels was lowest. Therefore, these techniques should be considered for first choice when appropriate. Furthermore, highly normal preoperative hematocrit serum levels and a meticulous surgical technique remain the mainstay of therapy in these patients.