A Second Mitral Valve Replacement in a Patient With Hereditary Hemorrhagic Telangiectasia (Osler's Disease)

Ishikawa, Susumu; Oshima, Kiyohiro; Aizaki, Masahiro; Takahashi, Toru; Morishita, Yasuo

doi:10.1536/jhj.45.885

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…Although we knew that our patient had AVMs and mucosal telangiectasia before her operation, she suffered only mild hemorrhage perioperatively. Her recurrent epistaxis resolved after the operation, as described in our previous case report [ 7 ]. Several measures were taken during the preoperative and postoperative periods to prevent life-threatening hemorrhage, including the administration of estrogen before the operation, not inserting a nasogastric tube, and discontinuance of anticoagulant drugs pre- and postoperatively [ 8 , 9 ].…”

Section: Discussionsupporting

confidence: 63%

Redo cardiac surgery for active prosthetic valve endocarditis associated with hereditary hemorrhagic telangiectasia: report of a case

et al. 2014

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Hereditary hemorrhagic telangiectasia (HHT) is caused by an autosomal dominant gene and characterized by multiple arteriovenous malformations in several organs, leading to bleeding or shunting. These patients often suffer severe infections and heart failure, which should be managed in the perioperative period, when open heart surgery is indicated. We report a case of successful aortic root replacement for active prosthetic valve endocarditis and ventricular septal perforation in a patient with HHT, who had severe heart failure.

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Section: Discussionsupporting

confidence: 63%

Redo cardiac surgery for active prosthetic valve endocarditis associated with hereditary hemorrhagic telangiectasia: report of a case

et al. 2014

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“…Despite the high risk of developing severe bacterial infections, infective endocarditis associated with HHT is relatively rare. To our knowledge, there are only eight cases of infective endocarditis in patients with HHT [ 9 – 16 ]. Among them, only two cases were treated medically without valvular surgery (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Infective endocarditis with Osler’s nodule in a patient with Osler’s disease: a case report and review of the literature

2022

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Background Hereditary hemorrhagic telangiectasia, also known as Osler–Weber–Rendu disease, induces arteriovenous malformations in visceral organs. Arteriovenous malformations increase the risk of severe infections and are a common complication associated with hemorrhagic telangiectasia. However, cases of endocarditis associated with hemorrhagic telangiectasia are rarely reported. Although hemorrhagic telangiectasia causes erythematous macules on the extremities, these macules are usually painless. We encountered a rare case of infective endocarditis in a patient with Osler–Weber–Rendu disease. Case presentation A 52-year-old Japanese woman who was diagnosed with hemorrhagic telangiectasia 5 years prior presented to our hospital with fever and muscular pain. She had erythematous nodules and tenderness on the finger, heel, and toe, suggestive of Osler’s nodes. A physical examination revealed tachycardia with a 3/6 pansystolic murmur. A transesophageal echocardiogram showed vegetations along the atrial side of the mitral valve and mild mitral regurgitation because of prolapse of the anterior commissure. Methicillin-sensitive Staphylococcus aureus was identified in the blood cultures. Detection of distinctive skin lesions, so-called Osler’s nodes, was the symptomatic key to early diagnosis, and the patient was treated without surgery. She was discharged with negative blood cultures after a 6-week intravenous antibiotic administration. Conclusions Our report highlights the importance of considering the risk of extracerebral infections including endocarditis in hemorrhagic telangiectasia. This rare case effectively demonstrates the importance of proper diagnosis of skin lesions.

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“…[3][4][5] To our knowledge, our patient is the first with HHT to undergo the Bentall operation following aortic valve replacement. Although a mechanical valve was selected in the first replacement operation, we used a tissue valve in the second, taking into consideration repetitive epistaxis and gastric bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Ishikawa, et al also reported the replacement of mitral valve with a tissue valve in a patient with HHT. 5) Benzadón, et al 3) recommend maintaining the activated clotting time >400s, which prevents bleeding by decreasing the activity of the coagulation system during surgery.…”

Section: Discussionmentioning

confidence: 99%

Bentall Operation for Prosthetic Valve Endocarditis with Hereditary Hemorrhagic Telangiectasia

Morita

Kimura

Yasuda

et al. 2014

ATCS

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Hereditary hemorrhagic telangiectasia (HHT; Osler-Weber-Rendu syndrome) is an uncommon disease characterized by abnormal telangiectasias and arteriovenous malformations that cause recurrent bleeding. Here, we present the case of a patient with HHT, who had a history of pulmonary and hepatic arteriovenous malformations and endocarditis of a prosthetic aortic valve that was caused by methicillin-resistant Staphylococcus aureus. The patient underwent the Bentall operation after coil embolization for pulmonary arteriovenous malformations. The postoperative course was uneventful.

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A Second Mitral Valve Replacement in a Patient With Hereditary Hemorrhagic Telangiectasia (Osler's Disease)

Cited by 8 publications

References 6 publications

Redo cardiac surgery for active prosthetic valve endocarditis associated with hereditary hemorrhagic telangiectasia: report of a case

Redo cardiac surgery for active prosthetic valve endocarditis associated with hereditary hemorrhagic telangiectasia: report of a case

Infective endocarditis with Osler’s nodule in a patient with Osler’s disease: a case report and review of the literature

Bentall Operation for Prosthetic Valve Endocarditis with Hereditary Hemorrhagic Telangiectasia

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