title: Transfusion-free complex cardiac surgery: with use of deep hypothermic circulatory arrest in a preterm 2.96-kg Jehovah's witness neonate.
abstract: In neonates, the major obstacle to transfusion-free complex cardiac surgery is the severe hemodilution that can result from the mismatch between the priming volume of the circuit and the patients' blood volume. Herein, we report the case of a 13-day-old, 2.96-kg preterm neonate who had a hypoplastic aortic arch and atrial and ventricular septal defects. At the insistence of her Jehovah's Witness parents, we performed corrective surgery without transfusing homologous blood products--using deep hypothermic circulatory arrest in the process. A specially designed cardiopulmonary bypass circuit with a priming volume of only 95 mL was the key component of an interdisciplinary effort to avoid transfusion while maintaining the patient's safety. To our knowledge, this is the 1st report of the use of deep hypothermic circulatory arrest in blood-transfusion-free surgery to correct congenital heart defects in a small Jehovah's Witness neonate.
authors.affiliation: Department of Cardiothoracic & Vascular Surgery, German Heart Institute, 13353 Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Huebler
authors.forename: Helmut
authors.initials: H
authors.lastname: Habazettl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Boettcher
authors.forename: Hermann
authors.initials: H
authors.lastname: Kuppe
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Matthias
authors.initials: M
authors.lastname: Redlin
mesh_terms: D001724:Birth Weight; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000009:adverse effects; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D033221:Jehovah's Witnesses; D012068:Religion and Medicine; D016896:Treatment Outcome; D016312:Treatment Refusal