Mitral Valve Repair in a Patient with Myelodysplastic Syndrome

Abstract

Open heart operations for patients with myelodysplastic syndrome (MDS) are associated with infective and bleeding complications. We report a 67-year-old woman with rheumatic, severe mitral regurgitation and mitral stenosis associated with MDS who underwent a mitral valve (MV) repair. Commissurotomy was performed in the anterior commissure. Autologous pericardial patch treated with glutaraldehyde solution was prepared. The anterior leaflet was completely detached from the posterior to the anterior commissure. The anterior leaflet was augmented by autologous pericardial patch treated with glutaraldehyde solution and three pairs of artificial chordae were implanted. Postoperative transesophageal echocardiography showed an increase in the MV orifice and less than trivial mitral regurgitation. Two years after the operation, the patient has normal sinus rhythm with no deterioration of the MV lesion by transthoracic echocardiography. Although the feasibility of MV repair is low in patients with restrictive pathology due to rheumatic disease, MV repair may be preferred in patients with MDS.

Minimally invasive mitral valve repair via right mini-thoracotomy in patient with myelodysplastic syndrome

“…Comprehensive prophylactic management including appropriate use of antibiotics and preoperative preparation also contributed to our good results. A high risk of wound infection after open heart surgery in patients with hematologic malignancies has been reported [ 3 ], including a case of mediastinitis following mitral valve repair in a patient with MDS [ 16 ]. In the present patient, we were not concerned about a sternum infection due to use of the MICS-mitral procedure, which might be another great advantage for patients with MDS.…”

Transcatheter aortic valve implantation in a patient with aplastic anemia

“…In addition, cardiopulmonary bypass during surgery is known to be associated with hemolysis, immunological dysfunction, coagulation dysfunction, and platelet dysfunction. For these reasons, open heart surgery in a patient with hematologic disorders is rare [1,2].…”

Mitral and Tricuspid Valvuloplasty in a Patient With Myel-Odysplastic Syndrome

“…[6][7][8] Samo je nekoliko pojedinačnih prikaza bolesnika s mijelodisplastičnim sindromom kod kojih je učinjen kirurški zahvat rekonstrukcije aortalne ili mitralne valvule, jer opsežan zahvat često dovodi do krvarenja te infektivnih komplikacija. [9][10][11][12][13][14][15][16][17][18][19] Dosad je u literaturi opisan samo jedan prikaz istodobnog izvođenja mitralne i trikuspidalne valvuloplastike.…”

“…Kardiokirurški zahvati u bolesnika s MDS-om rijetki su, uglavnom je riječ o aortokoronarnom premoštenju ili zamjeni aortalne ili mitralne valvule. [6][7][8][9][10][11][12][13][14][15][16][17][18] Operativni je postupak kompleksan. Ako bolesnik i preživi zahvat, postoji mogućnost postoperativnih komplikacija, kao i pogoršanja MDS-a.…”

“…Objavljeni su i pojedinačni prikazi bolesnika s kirurškim zahvatima zamjene aortalne ili mitralne valule. [9][10][11][12][13][14][15][16][17][18] Dayyani i suradnici analizirali su najčešće uzroke smrti bolesnika s MDS-om u skupini od 273 bolesnika s MDS-om niskog rizika i zaključili da su to najčešće infekcije (38%), transformacija u akutnu mijeloičnu leukemiju (15%) te krvarenja (13%). 19 Nekoliko je studija analiziralo perioperativni mortalitet i morbiditet pri kardiovaskularnim operacijama te je pokazano da je morbiditet veći kod trombocitopenije (trombociti < 50 × 10 9 /L), u starijih od 60 godina te pri hitnom kirurškom zahvatu kada se bolesnika ne može odgovarajuće pripremiti.…”