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Ann Thorac Surg 2000;69:935-937
© 2000 The Society of Thoracic Surgeons

Case Reports

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

Kagami Miyaji, MDa, Robert L. Hannan, MDa, Jorge W. Ojito, CCPa, Jeffrey A. White, MSa, Redmond P. Burke, MDa

a Division of Cardiovascular Surgery, Miami Children’s Hospital, Miami, Florida, USA

Address to reprint requests to Dr Burke, Division of Cardiovascular Surgery, Miami Children’s Hospital, 3200 SW 60 Court, Suite 102, Miami, FL 33155-4069

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.




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