In a rare incident, a ‘Jehovah witness’ patient successfully underwent a bloodless heart surgery at Fortis Hospital, Bannerghatta Road

The surgery specifically performed considering the no blood transfusion religious belief Bangalore, March 9, 2019: A 39 year old woman, Mrs Bibiche Tshibola Makolo , a native of Democratic Republic of the Congo suffering from a rare heart condition,restrictive cardiomyopathy with significant mitral valve obstruction & leakage with a severe tricuspid valve leakage (with a hemoglobin of 7gm%) ,successfully underwent a bloodless open heart surgery at Fortis Hospital, Bannerghatta Road. The patient belongs to Jehovah witness community who observe and follow a faith-based prohibition against receiving blood or blood products transfusion. The team of doctors who performed the surgery was led by Dr. Vivek Jawali, Chief Cardiothoracic and Vascular Surgeon, Chairman, Department of Cardiovascular Sciences, Fortis Hospitals, Bangalore and Dr. Murali Chakravarthy, Director, Dept of Anaesthesia, Fortis Hospital, Bangalore. The patient had specially flown down to India to get the treatment as many countries and centers had refused surgery on her. Their cornerstone of faith lies in not accepting allogeneic blood or the blood which has gone out of circulation from their own body which means even an auto transfusion is not allowed if the blood has left the body stored outside. Therefore, a bloodless open heart surgery of Mital valve replacement and tricuspid valve repair in the high risk setting of a poorly contracting heat and a religious restriction of no blood or blood product transfusion was performed on Mrs. Bibiche. Dr. Vivek Jawali, Chief Cardiothoracic and Vascular Surgeon, Chairman, Department of Cardiovascular Sciences, Fortis Hospitals, Bangalore said, “Mrs Makolo had severe restrictive cardiomyopathy in which there is restrictive filling of the ventricles. She required immediate surgery, however her religious belief was not allowing her to proceed with the conventional method of treatment, which may require blood transfusion. With due respect to her religious beliefs, we recommended her to undergo bloodless surgery wherein a peri-operative plan was set by haematologist, the anaesthetist and team of cardiac surgeons. We put the patient on a series of medications including blood conservatives which helped increasing her haemoglobin level to 14.8 g/dL. Using all the blood conservation techniques which is practiced at our unit for all patients, the surgery was conducted. It was successful and no blood transfusion was required during the entire procedure.” Dr. Murali Chakravarthy, Director, Dept of Anesthesia, Fortis Hospital, Bangalore, said, “This case was a challenge in itself as we were restricted towards blood transfusion. Generally, a bloodless surgery is a risky situation and can lead to hemorrhagic shock in the patient, however she responded well to the treatment. Routinely at our unit, we practice stringent blood conservation methods, which came in handy in Bibiche’s case. We had ensured the patient and her family that their religious belief was duly respected and we would not conduct any blood transfusion during the surgery. The patient is recovering fast and will move to her country soon”. Husband of Mrs Bibiche, said, “We were very worried about her treatment as we belong to Jehovah Witness community and were not sure if we would receive a treatment wherein our beliefs are considered. We were referred to Fortis Hospital where we got complete support from the doctors. I am extremely grateful to Dr Vivek Jawali and Dr Murali Chakravarthy for their constant support and cooperation throughout the procedure.”