Williams Mallory, Blocksom Jason M, Baciewicz Frank A
Division of Cardiothoracic Surgery, Wayne State University, Detroit, Michigan 48201, USA.
Tex Heart Inst J. 2004;31(2):181-3; discussion 183.
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.
我们报告一例患有依赖透析的慢性肾衰竭及左主干冠状动脉疾病的耶和华见证会信徒接受冠状动脉旁路移植术的病例。回顾了术前、术中和术后的管理情况。该患者接受了2次冠状动脉血运重建手术（1次体外循环手术和1次非体外循环手术）。对于患有依赖透析的慢性肾衰竭的耶和华见证会信徒患者，通过尽可能选择择期手术、在手术期间应用非体外循环旁路和自体输血技术来限制失血、在术前和术后使用促红细胞生成素和硫酸亚铁来提高血红蛋白水平，以及在术后使用强心剂来维持氧输送，可以安全地进行冠状动脉旁路移植术。
