losartan-potassium and Aortic-Dissection

Blood-sparing surgical technique and perioperative medical management allows complex surgery in Jehovah's Witnesses. The authors review four cases of urgent cardiothoracic surgery performed on Jehovah's Witnesses. No lasting sequelae associated with either bleeding or end-organ ischemia were noted. Cardiopulmonary bypass management, meticulous hemostatic operative technique, and pharmacologic support of hemostasis and erythropoiesis permit this complex surgery.

Topics: Adult; Aged; Anti-Bacterial Agents; Aortic Aneurysm; Aortic Dissection; Aprotinin; Blood Transfusion, Autologous; Blood Vessel Prosthesis Implantation; Cardiac Surgical Procedures; Cardiac Tamponade; Combined Modality Therapy; Comorbidity; Endocarditis, Bacterial; Erythropoietin; Female; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Hematocrit; Hemodilution; Humans; Iron; Jehovah's Witnesses; Male; Patient Acceptance of Health Care; Preoperative Care; Streptococcal Infections; Treatment Refusal; Viridans Streptococci

The thromboexclusion technique was used to treat a massive thoracic aneurysm in a Jehovah's witness. Preoperative erythropoietin therapy was used. At operation a Hemashield graft was used to bypass the aneurysm before the mouth was stapled closed. The hemoglobin level fell from 13.5 to 10.6 g/dL.

Topics: Aortic Aneurysm, Thoracic; Aortic Dissection; Blood Vessel Prosthesis; Christianity; Embolization, Therapeutic; Erythropoietin; Humans; Male; Middle Aged; Surgical Staplers