ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

 Click here to read this article as a CME activity

Ann Thorac Surg 2012;93:19-25. doi:10.1016/j.athoracsur.2011.06.029
© 2012 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Arminder Singh Jassar
Joseph E. Bavaria
Charles R. Bridges
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jassar, A. S.
Right arrow Articles by Bridges, C. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jassar, A. S.
Right arrow Articles by Bridges, C. R.
Related Collections
Right arrow Cardiac - other
Right arrowRelated Article

Original Articles: Adult Cardiac

Cardiac Surgery in Jehovah's Witness Patients: Ten-Year Experience

Arminder Singh Jassar, MBBSa, Patricia A. Ford, MDb, Howard L. Haber, MD, FACCc, Alice Isidro, PAa, Jabaris D. Swain, MDa, Joseph E. Bavaria, MDa, Charles R. Bridges, MD, ScDd,*

a Division of Cardiovascular Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
b Division of Hematology and Oncology, Pennsylvania Hospital, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
c Division of Cardiovascular Medicine, Pennsylvania Hospital, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
d Department of Thoracic and Cardiovascular Surgery, Sanger Heart and Vascular Institute, Carolinas Healthcare System, Charlotte, North Carolina

Accepted for publication June 14, 2011.

* Address correspondence to Dr Bridges, Department of Thoracic and Cardiovascular Surgery, Sanger Heart and Vascular Institute, Carolinas Healthcare System, 1001 Blythe Blvd, Ste 300, Charlotte, NC 28203 (Email: charles.bridges{at}carolinashealthcare.org).

Background: Cardiac surgery in Jehovah's Witnesses poses unique challenges. We have developed a comprehensive multimodality program for these patients and have obtained excellent results.

Methods: Ninety-one Jehovah's Witness patients underwent cardiac surgery between 2000 and 2010. Preoperative, intraoperative, and postoperative considerations in the conduct of bloodless surgery in the Jehovah's Witness population are discussed. Mortality for isolated coronary artery bypass graft surgery and isolated aortic valve replacement was compared with predicted mortality from The Society of Thoracic Surgeons (STS) risk models. Perioperative outcomes were stratified by urgent and elective status of operations.

Results: Mean age was 65 ± 12.4 years. Comorbid conditions included hypertension (84.6%), diabetes mellitus (48.4%), previous myocardial infarction (23.1%), chronic lung disease (38.5%), peripheral vascular disease (20.9%), and renal failure (11%). In-hospital mortality was 5.5% (n = 5). Mortality for isolated coronary artery bypass graft surgery and isolated aortic valve replacement was 2.2% (observed to expected ratio = 1.05, 95% confidence interval: 0 to 3.02) and 5.6% (observed to expected = 1.46, 95% confidence interval: 0 to 3.76), respectively. Other complications included reoperation (all = 8.8%, cardiac = 2.2%), sepsis (2.2%), sternal wound infection (1.1%), transient ischemic attack (1.1%), renal failure requiring dialysis (1.1%), and prolonged ventilation (18.7%). Major complication rates were not significantly different between the elective group and the urgent group.

Conclusions: Bloodless cardiac surgery in Jehovah's Witness patients can be performed with excellent outcomes in both elective and urgent situations. Mortality rates for isolated coronary artery bypass graft surgery and isolated aortic valve replacement are within the expected 95% confidence intervals of STS predicted mortality.


Related Article

Invited Commentary
Andrea J. Carpenter
Ann. Thorac. Surg. 2012 93: 25. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
V. A. Ferraris, S. P. Saha, J. H. Oestreich, H. K. Song, T. Rosengart, T. B. Reece, C. D. Mazer, C. R. Bridges, G. J. Despotis, K. Jointer, et al.
2012 Update to The Society of Thoracic Surgeons Guideline on Use of Antiplatelet Drugs in Patients Having Cardiac and Noncardiac Operations
Ann. Thorac. Surg., November 1, 2012; 94(5): 1761 - 1781.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Polat, E. B. Polat, and N. Kayalar
Perioperative Acute Kidney Injury After Cardiac Surgery
Ann. Thorac. Surg., November 1, 2012; 94(5): 1785 - 1786.
[Full Text] [PDF]

Home page
 Interact CardioVasc Thorac SurgHome page
E. Elmistekawy, T. G. Mesana, and M. Ruel
Should Jehovah's Witness patients be listed for heart transplantation?
Interact CardioVasc Thorac Surg, October 1, 2012; 15(4): 716 - 719.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. J. Carpenter
Invited Commentary
Ann. Thorac. Surg., January 1, 2012; 93(1): 25 - 25.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2012 by The Society of Thoracic Surgeons.