Coronary artery bypass grafting in a dialysis-dependent Jehovah's Witness.

We present a case of coronary artery bypass grafting in a Jehovah's Witness with dialysis-dependent chronic renal failure and left main coronary artery disease. The preoperative, intraoperative, and postoperative management is reviewed. This patient underwent 2 coronary revascularization operations (1 on-pump and 1 off-pump). Coronary artery bypass grafting can be performed safely in the Jehovah's Witness patient with dialysis-dependent chronic renal failure by performing the operation electively if possible, limiting blood loss through the application of off-pump bypass and autologous transfusion techniques during surgery, increasing hemoglobin during both the pre- and postoperative periods by using erythropoietin and ferrous sulfate, and maintaining oxygen delivery during the postoperative period by the use of inotropic agents.