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一名耶和华见证人的主动脉瓣置换术:一例无血手术的多学科临床管理病例

Aortic valve replacement in a Jehovah's Witness: a case of multi-disciplinary clinical management for bloodless surgery.

作者信息

Park John Jungpa, Lang Christopher C, Manson Lynn, Brackenbury Edward T

机构信息

University of Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK.

出版信息

BMJ Case Rep. 2012 Feb 21;2012:bcr1220115403. doi: 10.1136/bcr.12.2011.5403.

Abstract

An 81-year-old female Jehovah's Witness (JW) patient with severe aortic stenosis required aortic valve replacement (AVR). However, the patient's religious beliefs precluded the use of primary blood components. Since the definitive treatment of AVR required bloodless open heart surgery, careful peri-operative plans were set forth by a multi-disciplinary team involving the cardiothoracic surgeon, haematologist and anaesthetist. The patient went on to successfully recover postoperatively. This case highlights: 1) The importance of carefully navigating through the most recent clinical and ethical protocol involved in the surgical management of JW's. 2) The importance of preparing individually tailored pre, intra and postoperative plans that are delivered through a multi-disciplinary clinical team to ensure the best and safest possible outcomes.

摘要

一名81岁的女性耶和华见证会(JW)信徒患者患有严重的主动脉瓣狭窄,需要进行主动脉瓣置换术(AVR)。然而,患者的宗教信仰禁止使用主要血液成分。由于AVR的最终治疗需要无血心脏直视手术,一个由心胸外科医生、血液学家和麻醉师组成的多学科团队制定了详细的围手术期计划。该患者术后成功康复。本病例突出了:1)在JW患者手术管理中仔细遵循最新临床和伦理规范的重要性。2)通过多学科临床团队制定个性化的术前、术中和术后计划以确保获得最佳和最安全结果的重要性。

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