Resection of a Large Atrial Hemangioma Using a Bloodless Surgical Technique: A Case Report
AbstractWe present a biatrial hemangioma in a Jehovah's Witness patient. Hemangioma is extremely rare, accounting for 1% to 2% of benign cardiac tumors. Complete resection of a large hemangioma is mandatory due to its potentially life-threatening risk. In Jehovah's Witness patients, it is necessary to employ bloodless surgery protocols to maximize the patient's outcome. Our patient had undergone 6 weeks of monitoring and erythropoietin therapy prior to surgery, raising her hemoglobin level from 11.6 g/dL to 16.8 g/dL. Intraoperative bloodless surgical protocols as well as a continuous blood circuit were utilized. The patient's hemoglobin level on postoperative day one was 14.5 g/dL; one year postsurgery, the patient was symptom free.
Alexi-Meskishvili V, Stiller B, Koster A, et al. 2004. Correction of congential heart defect in Jehovah's Witness children. Thorac Cardiovasc Surg 52:141-6.nChang JS, Young ML, Lue HC. 1992. Infantile cardiac hemangioendothelioma. Pediatr Cardiol 13:52-5.nGohel MA, Bulbullia RA, Slim FJ, Poskitt KR, Whyman MR. 2005. How to approach major surgery where patients refuse blood transfusion (including Jehovah's Witness). Ann R Coll Surg Engl 87:3-14.nPalmer TE, Tresch DD, Bonchek LI. 1986. Spontaneous resolution of a large, cavernous hemangioma of the heart. Am J Cardiol 58:184-5.nRosengart TK, Helm RE, DeBois WJ, Garcia N, Krieger KH, Isom OW. 1997. Open heart operations without transfusion using a multimodality blood conservation strategy in 50 Jehovah's Witness patients: implications for a "bloodless" surgical technique. J Am Coll Surg 184:618-29.nShander A, Rijhwani TS. 2005. Clinical outcomes in cardiac surgery: conventional surgery versus bloodless surgery. Anesthesiol Clin North America 23:327-45.nStrauss R, Merlis R. Primary tumors of the heart. Arch Pathol 1945;39:74.nSutton SW, Duncan MA, Chase VA, Cheung EH, Hamman BL. 2004. Leukocyte filtration and miniature perfusion during arrested heart CABG on a Jehovah's Witness patient. Perfusion 19:375-9.n
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