Redo cardiac surgery in a Jehovah's Witness, the importance of a multidisciplinary approach to blood conservation

Although Jehovah's Witnesses present a particular problem when undergoing s urgery because of their refusal to accept stored blood, it is now quite com mon to undertake uncomplicated cardiac surgery in these patients. Complex o r redo cardiac surgery however, is often associated with major blood loss, and is conventionally contraindicated in Jehovah's Witnesses. We describe t he perioperative management of a Jehovah's Witness who underwent a resterno tomy for mitral valve replacement and coronary artery bypass grafting havin g previously had an aortic valve replacement and mitral valve repair. The i mportance of a multidisciplinary approach to blood conservation is discusse d.