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(781) Sanguine Success: Bloodless Implantation of a LVAD in a Jehovah's Witness by R. Umrani; R. Judge; V. Singh; M. Moshiyakhov; K. Barn; R.E. Ross is a Medicine article available to read on EtoBox.

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Introduction Jehovah's Witnesses (JW) represent a minority population with outsized medical challenges because they do not accept blood or blood products. This should not preclude these patients from advanced heart failure therapies such as left ventricular assist device (LVAD) implantation. Case Report A 52 year old male, who was previously denied LVAD by other institutions due to his JW status, presented with worsening dyspnea on exertion and new shortness of breath at rest despite having his chronic milrinone infusion up-titrated two weeks prior. Physical exam was positive for jugular venous distension, trace bilateral lower extremity edema, and cool extremities. Echocardiogram demonstrated an ejection fraction of 10-15%. Right heart catheterization confirmed worsening cardiogenic shock necessitating repeat LVAD evaluation. He was escalated to dual inotrope therapy with minimal hemodynamic improvement. This was complicated by refractory ventricular tachycardia leading to further clinical decompensation requiring emergent balloon pump placement. A hemoglobin (Hb) optimization protocol was initiated 3 days prior to surgery. He was given 20,000 units epoetin alfa for 10 days, 100 m

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Author

R. Umrani; R. Judge; V. Singh; M. Moshiyakhov; K. Barn; R.E. Ross

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)