OPCAB Revascularization In Jehovah´s Witness Patients
Helmut Mair, Peter Lamm.
Cardiac Surgery, Chirurgisches Klinikum München Süd, Munich, Germany.
OBJECTIVE: Jehovah's Witness (JW) community refuses any blood products transfusions. Therefore special treatment strategies are demanded to perform safe operations. Aim of the study was to evaluate the results JW patients undergoing off pump coronary artery bypass (OPCAB) surgery.
METHODS: Between September 2013 and January 2019, 15 patients (20% female) received OPCAB by the same surgical team. Mean age was 68.12 ±7.29 years. Preoperative strategy included Erythropoietin administration to patients with a hemoglobin value under 11.5 g/dl and discontinuation of all anti platelet drugs. Intraoperatively a cellsaver and a hemostatic starch powder were used for bleeding control from sternum (or any tissue) and anastomotic oozing. All patients had a follow up every 6 months up to 2 years.
RESULTS: Patients received 2,3±0,7 bypass-grafts. All patients had the left thoracic artery as graft. Preoperative Hemoglobin (Hb) level was 14.20 ± 0.90 mg/dl. Perioperatively the Hb levels decreased to the mean level of 9.60 ±1.24 mg/dl. On discharge Hb levels were 11.38±1.49 mg/dl. Discharge from hospital was after 12,8±2,5 days. One patient suffered from sternum wound infection requiring vacuum-assisted therapy and one patient had a readmission for dyspnea treated conservatively. During the hospital stay and follow-up period no patient died.
CONCLUSIONS: With careful perioperative patient care OPCAB is a safe strategy in JW for operative revascularization. Nevertheless, low Hb was a limiting factor for prompt postoperative discharge.
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