City-based Narayana Hrudayalaya successfully conducted beating heart CABG surgery on a 74-year-old US citizen who is a Jehovah’s Witness, a Christian denomination that discourages blood transfusion.

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Jack Jones underwent the surgery in December, without blood transfusion. He did not have significant blood loss. He followed up with routine check-up two weeks later and was found to be having a haemoglobin level of 13.5, which is within the normal range for an adult.

At a press meet on Saturday, Jones said he did a detailed research on Internet to select the hospital for his treatment and zeroed in on five hospitals; with their family physician recommending Narayana Hrudayalaya.

Dr Sharad Damodar, haematologist, Mazumdar-Shaw Cancer Centre, said any patient accepted for bloodless cardiac surgery should be first evaluated by a haematologist. He said patients are evaluated for their haemoglobin levels and possible bleeding tendencies. Some patients, including Jehovah’s Witnesses, can suffer some disorders of the blood-clotting mechanism, which can cause bleeding during surgery.

The operation team is made aware that blood transfusion is to be totally avoided in Jehovah’s Witnesses. A medicine called heparin is given during the surgery to prevent the formation of blood clot. Soon after the surgery, heparin is neutralised by a medicine called protamine. A surgeon has to exercise utmost care in preventing loss of even one drop of blood in such a scenario. Bypass surgeries on Jehovah’s Witnesses are done preferably without using the heart lung machine, on a beating heart, said Praveen Kumar, senior consultant cardiac surgeon, Narayana Hrudayalaya.