Staged open surgery for bicuspid aortic valve regurgitation and coarctation of the aorta in a Jehovah's witness.

<bold>Background: </bold>Jehovah's Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging. Surgeons must minimize blood and fluid loss within one procedure.<bold>Case Presentation: </bold>We herein describe a 17-year-old male Jehovah's Witness with bicuspid aortic valve regurgitation and coarctation of the aorta. The procedures were performed in the following order: aortic valve replacement combined with Nick's aortic root enlargement, right axillary artery-bilateral external iliac artery bypass, and distal arch-descending aorta bypass.<bold>Conclusions: </bold>Axillary artery-bilateral external iliac artery bypass maintained distal perfusion and reduced the amount of heparin during distal arch-descending aorta bypass surgery. [ABSTRACT FROM AUTHOR]