Minimally Invasive Approach versus Sternotomy for Cardiac Surgery in Jehovah's Witness Patients

Objective: To evaluate the outcomes of minimally invasive cardiac surgery (MICS) compared with the sternotomy approach for Jehovah's Witness (JW) patients who cannot receive blood transfusions Design: This was a retrospective observational study. Setting: The study was conducted at a specialized cardiovascular intervention and surgery institute. Participants: The study cohort comprised JW patients undergoing cardiac surgery between September 2016 and July 2022. Measurements and Main Results: Patients (n = 63) were divided into MICS (n = 19) and sternotomy (n = 44) groups, and clinical outcomes were analyzed. There was no difference in types of operation except coronary bypass grafting (n = 1 [5.3%] in the MICS group v n = 20 [45.5%] in the sternotomy group; p = 0.005). There were no between-group differences in early mortality and morbidities. Overall survival did not differ significantly during the follow-up period (mean, 43.9 f 24.4 months). The amount of chest tube drainage was significantly lower in the MICS group on the first postoperative day (mean, 224.0 f 122.7 mL v 334.0 f 187.0 mL in the sternotomy group; p = 0.022). The mean hemoglobin level was significantly higher in the MICS group on the day of operation (11.7 f 1.3 mg/dL v 10.6 f 2.0 mg/dL in the sternotomy group; p = 0.042) and the first postoperative day (12.3 f 1.8 mg/dL v 11.2 f 1.9 mg/dL; p = 0.032). Conclusions: MICS for JW patients showed favorable early outcomes and mid-term survival compared to conventional sternotomy. MICS may (c) 2024 Elsevier Inc. All rights reserved.