Staged repair for a chronic dissecting thoracic aortic aneurysm with no transfusion in a Jehovah's Witness patient

We present the case of a 59-year-old male Jehovah's Witness who underwent staged repair for a thoracic aortic aneurysm with no transfusion. The primary operation to replace the distal portion of the aortic arch and left subclavian artery reconstruction were performed. We applied axilla–femoral artery temporary external bypass. A second operation was carried out 8 months later. We replaced the descending aorta and reconstructed the intercostal arteries under temporary bypass in the same manner as was done during the previous operation. The blood losses and minimum hemoglobin values during the two operations were 2235 and 13 941 ml, respectively, 8.8 and 5.9 g/dl, respectively. Administration of erythropoietin and a drainage blood recovery device were useful. Surgical repair for a thoracic aortic aneurysm using a temporary bypass is thus considered a viable surgical option in such situations and is important for conducting effective perioperative management.