Hybrid Operation for Combined Aortic Arch Aneurysm and Aortic Root Dilation in a Jehovah's Witness Patient

Aortic surgery for Jehovah's Witness patients with extended aneurysms is challenging. The present report describes a case of a 65-year-old male Jehovah's Witness with aortic aneurysm that extended from the ascending to the transverse aortic arch. Two-stage hybrid operation was performed as follows: ascending aortic replacement with debranching of brachiocephalic artery, followed by extra-anatomic bypass of cervical arteries, and thoracic aortic stent-grafting. The patient fully recovered without complication, and the lowest hemoglobin concentration during the hospital admission was 9.5 g/dL. We conclude that the hybrid procedure was effective in securing a margin of safety for bloodless aortic surgery.