Coronary artery bypass grafting in a dialysis-dependent Jehovah's Witness.
We present a case of coronary artery bypass grafting in a Jehovah's Witness with dialysis-dependent chronic renal failure and left main coronary artery disease. The preoperative, intraoperative, and postoperative management is reviewed. This patient underwent 2 coronary revascularization operations (1 on-pump and 1 off-pump). Coronary artery bypass grafting can be performed safely in the Jehovah's Witness patient with dialysis-dependent chronic renal failure by performing the operation electively if possible, limiting blood loss through the application of off-pump bypass and autologous transfusion techniques during surgery, increasing hemoglobin during both the pre- and postoperative periods by using erythropoietin and ferrous sulfate, and maintaining oxygen delivery during the postoperative period by the use of inotropic agents.
Williams
Mallory
M
Division of Cardiothoracic Surgery, Wayne State University, Detroit, Michigan 48201, USA.
Blocksom
Jason M
JM
Baciewicz
Frank A
FA
D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D033221:Jehovah's Witnesses; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D006435:Renal Dialysis