Bloodless Third Reoperative Multivalvular, Aortic, and Double-Chamber Right Ventricular Surgery in a Jehovah's...

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.

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.

This case highlights the feasibility of high-risk, bloodless congenital reoperations through careful perioperative planning, preoperative imaging, and adherence to institutional blood conservation protocols.

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.