Complex Cardiac Surgery in Jehovah's Witnesses With Chronic Renal Failure

摘要

A 85-year-old, 65-kg JW woman was admitted to this center with angina and dyspnea. She had recent worsening of her symptoms, with admission to another hospital for decompensated heart failure. She also had hypertension treated with furosemide and enalapril, chronic atria! fibrillation treated with amiodarone, and CRF. Laboratory analysis revealed creatinine of 2.5 mg/dL (calculated creatinine clearance of 16.9 mL/min) and Hb of 10.4 g/dL. Transthoracic echocardiography showed severe aortic stenosis with moderate mitral insufficiency, and cardiac catheterization showed critical stenosis of the left anterior descending and the right coronary arteries. After clear explanation of the high surgical risk (logistic EUROSCORE 18.76%) and acceptance by the patient and her relatives, the patient was discharged on treatment with EPO, folic acid, and iron as described earlier.