title: Repair of a large main pulmonary artery aneurysm in a 71-year-old Jehovah's Witness patient.
abstract: Pulmonary artery aneurysm is a rarely reported and poorly studied entity; most mentions in the literature are in case series and case reports. Cardiac surgery in Jehovah's Witness patients is occurring more frequently because of improved techniques of blood conservation. We report the repair of a large pulmonary artery aneurysm in a 71-year-old woman who was a Jehovah's Witness. Using total cardiopulmonary bypass, we replaced the main pulmonary artery and both branches with Gelweave tube-grafts, because the fragility of a homograft presented possible bleeding problems. The patient recovered rapidly, and her symptoms were greatly improved. We think that a patient's status as a Jehovah's Witness need not preclude potentially life-saving cardiac operations.
authors.affiliation: Department of Cardiothoracic Surgery, Cedars-Sinai Heart Institute, Los Angeles, California 90048, USA. lucaswhenn@gmail.com
authors.forename: Lucas W
authors.initials: LW
authors.lastname: Henn
authors.forename: Fardad
authors.initials: F
authors.lastname: Esmailian
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057668:Bloodless Medical and Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006400:Hematocrit; D006801:Humans; D033221:Jehovah's Witnesses; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012068:Religion and Medicine; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016312:Treatment Refusal
keywords: Aneurysm/surgery; Jehovah's Witnesses; blood loss, surgical/prevention & control; blood transfusion, autologous/contraindications; cardiopulmonary bypass/methods; factor VIIa/therapeutic use; patient acceptance of health care; pulmonary artery/pathology/surgery; treatment outcome
references.citation: Ann Thorac Surg. 2009 Jul;88(1):273-5
references.pmid: 19559243
references.citation: Anesth Analg. 2007 Apr;104(4):763-5
references.pmid: 17377078
references.citation: Ann Thorac Surg. 2001 May;71(5):1688-90
references.pmid: 11383829
references.citation: Heart Surg Forum. 2007;10(4):E273-5
references.pmid: 17599873
references.citation: Chest. 1988 Nov;94(5):1065-75
references.pmid: 3053058
references.citation: Am Heart J. 1947 Oct;34(4):471-99
references.pmid: 20266464
references.citation: J Thorac Cardiovasc Surg. 1971 Jul;62(1):63-7
references.pmid: 5091687
references.citation: Ann Thorac Surg. 2005 Oct;80(4):1504-6
references.pmid: 16181903