Open Cardiac Repair Using Controlled Cross-circulation in an Infant of a Jehovah's Witness Sympathizer Mother / 日本心臓血管外科学会雑誌

ABSTRACT

Blood transfusion is usually required to perform open cardiac surgical repair in small infants, but the use of blood might be rejected by parents on religious grounds. We operated on a 1.4 years old boy with ventricular septal defect (VSD) and severe (grade 3/4) mitral regurgitation (MR) due to elongated anterior chordae, whose mother was a “Jehovah's witness” sympathizer, initially rejecting any blood transfusion. In view of the deteriorating condition of the infant, and the inadequacy of the pulmonary artery banding alone as therapeutic modality, the mother was persuaded to ultimately consent to controlled cross-circulation between her and the child. The arterial blood was pumped with a roller pump from the mother's femoral artery to the infant's ascending aorta; caval venous return of the infant was drained by gravity into a reservoir and then pumped into the femoral vein of the mother by a second roller pump. A large membranous ventricular septal defect and the mitral regurgitation were repaired (patch closure of the VSD, and shortening of the elongated anterior papillary muscle chordae in conjunction with Kay's type mitral annuloplasty for the MR) during a cross-circulation time of 212min. 2.2 years after the operation, both, the infant and the mother, enjoy good health.