Introduction: Complex aortic surgery involving Jehovah’s Witness patients presents a significant challenge due to their refusal of blood products.

 

Case report: This case report details the management of a 50-year-old female Jehovah’s Witness with anaemia and a low body surface area, undergoing an urgent ascending aorta and hemi-arch replacement for a type A dissection. A broad range of blood conservation strategies were utilised in order to preserve haematocrit and clotting factors.

 

Conclusions: This report highlights the importance of careful planning, team collaboration, and the meticulous application of blood conservation techniques in achieving a favourable postoperative outcome.