LVHN's Bloodless Surgery Program Makes Open-Heart Surgery Possible Without Blood Transfusions

Deborah “Debbie” Rinier, 69, of Macungie, knew she had a heart murmur her entire life. Up until March 2021, it had never caused any major health issues. But during her yearly exam, her physician noticed that her murmur had significantly worsened. By the time she went to her follow-up appointment in August 2021, she had started to feel the effects of her murmur.

“I had no energy because my heart wasn't pumping correctly. I could barely walk, and it got to the point where I couldn’t do any housework, cook or clean. It was physically exhausting and getting worse,” she says.

She had tests done and could barely walk for one minute. Debbie was diagnosed with left ventricular outflow tract obstruction due to a medical condition called hypertrophic cardiomyopathy (HCM). She would need a surgery called septal myectomy but had reservations due to her religious beliefs.

As one of Jehovah's Witnesses, Debbie has a faith-based objection to blood transfusions. To meet her needs, her cardiologist, Nael Hawwa, MD, with Lehigh Valley Heart and Vascular Institute, referred her to LVHN’s Patient Blood Management and Bloodless Surgery Program. She was connected with Kelly Frinzi, Patient Liaison for the program, who worked with Debbie to learn and listen to her needs.

“We held a virtual consultation with her to discuss the alternatives for bloodless surgery that are offered through our program,” says Frinzi. “We work hard to make sure our patients receive the treatment they need while respecting their personal convictions and preferences. You not only have a patient advocate by your side, but we are there before, during and after surgery.  We treat you as we would our own family.”

Debbie was referred to cardiothoracic surgeon James K. Wu, MD, with Lehigh Valley Heart and Vascular Institute, who would perform her surgery. To prepare her for bloodless surgery, she was also referred to hematologist Bradley Lash, MD, with Lehigh Valley Topper Cancer Institute, who optimized her blood before surgery with iron infusions.

“We abide by the specific rules and wishes of the Jehovah’s Witness community so that their religious convictions can be upheld,” explains Wu. “In cardiac surgery, there is always going to be a certain amount of blood loss associated with the conduct of the operation. Sometimes, this means 20 to 25% of the total volume. We do a very comprehensive pre-op preparation to ensure adequate blood volume within the patient in conjunction with the Patient Blood Management and Bloodless Surgery Program and Hematology.”

Wu adds that the surgery is also slower than usual. This allows the surgical team to account for and control all the bleeding sources to the extent possible during the operation. 

Debbie was scheduled for surgery on November 12, 2021, and everything went according to plan.

“Dr. Wu did such a great job, and my whole experience at LVHN was off the charts,” says Debbie.  “Kelly was just great – she is my girl. She knew how to help keep me patient and calm.”

After her surgery, Debbie spent a few days recovering in the ICU.

“My care team kept checking on me. It was a huge team effort, and everything ran so smoothly,” she says.

Once she was ready, Debbie went home to fully recover.

“I am feeling so much better. I'm not in any pain, and within four weeks I felt fantastic. My friends and family can't get over it,” she says. “They tell me, ‘You don't look like someone who's had open heart surgery!’ I have started cooking dinner again, and I'm back to doing the laundry and ironing.”

She’s incredibly grateful for her care and the effort of the Patient Blood Management and Bloodless Surgery Program.

“My care was meticulous. The Patient Blood Management and Bloodless Surgery Program went an extra step to make sure everything would be OK,” she says. “As one of Jehovah's Witness, I had no reservations at all for the procedure. Kelly and her team always reassured me, and everything was just perfect.”