[A case of Jehovah's Witness underwent double valves replacement in reoperation]

The patient was a sixty five-year-old woman and Jehovah's Witness who refused either homologous or autologous blood transfusion on the ground of her faith. At the age of 47, she had closed commissurotomy for mitral valve stenosis. This time, because mitral valve restenosis and tricuspid valve regurgitation were found, double valve replacement, mitral and tricuspid, was performed on her, with an excellent result. It is expected that, in the near future, the indication for open heart surgery without blood transfusion will be increased by means of the following considerations as to blood loss preservation; 1. to shorten the time necessitating for an operation and reduce preoperative blood loss, 2. to improve cardio-pulmonary bypass system (Heparin coating etc), and 3. to augment the erythropoiesis (administration of EPO at the patient's own expense, etc.) and so on.