Tricuspid valve relocation with endomyocardial fibrosis removal for Löeffler’s endocarditis

Asai, Tomohiro; Miyashita, Fumihiro; Nota, Hiromitsu; Vigers, Piers

doi:10.1093/ejcts/ezy487

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…In some cases, timely emergency surgical intervention may be necessary, particularly when patients experience cardiac valve dysfunction, dramatic decreased cardiac output and obstruction. 10 , 11 In this case, the patient underwent emergency surgery, coupled with corticosteroid therapy, which led to a positive prognosis during the 3 months follow-up. This case highlights the effectiveness of timely surgical intervention combined with corticosteroid therapy in selected patients.…”

Section: Discussionmentioning

confidence: 81%

A case report of Löffler’s endocarditis with right ventricular outflow obstruction in idiopathic hypereosinophilic syndrome: timely surgical intervention is crucial

Zeng,

Peng,

Guan

et al. 2024

European Heart Journal - Case Reports

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Background Löffler’s endocarditis (LE) is a frequently encountered condition in hypereosinophilic syndrome and is associated with a significant morbidity and mortality rate. Case Summary A 22-year-old man presented with acute dyspnoea, recurring wheezing, and cough, leading to his hospital admission. Multimodal diagnostic imaging revealed a manifestation of eosinophil-mediated cardiac injury in the thrombus formation stage. Moreover, a mural thrombus and thickened endocardium had caused severe obstruction of the right ventricular outflow tract (RVOT) and complete obliteration of the right ventricular apex, resulting in a significant reduction in right ventricular cardiac output. The patient received a diagnosis of LE and was treated with high-dose corticosteroids and anticoagulants. To alleviate the RVOT obstruction, an emergency surgical intervention was conducted through median sternotomy to the removal of the mural thrombus and resection of the thickened endocardium. Subsequently, eosinophil counts normalized within 1 month. Follow-up imaging examination demonstrated the existence of a residual section of thickened endocardium within the right ventricular free wall. Importantly, no mural thrombus was detected with complete relief of the RVOT obstruction. Notably, a transthoracic echocardiography examination at the 3-month postoperative unveiled a significant regression in right ventricular endomyocardial fibrosis. The patient’s condition exhibited tangible improvement, with no adverse events observed. Discussion Multimodal imaging is essential for the early diagnosis and accurate staging of LE. Timely surgical intervention, combined with corticosteroid therapy, is an effective therapeutic approach in selected patients with LE. This approach is crucial to achieve remission of acute phase symptoms and improve prognosis.

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Section: Discussionmentioning

confidence: 81%

A case report of Löffler’s endocarditis with right ventricular outflow obstruction in idiopathic hypereosinophilic syndrome: timely surgical intervention is crucial

Zeng,

Peng,

Guan

et al. 2024

European Heart Journal - Case Reports

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“…The other methods of surgical treatment reported in patients with CMP are intracardiac assist device implantation and heart transplantation, with 87%, 81%, and 74% survival at 1, 3, and 5 years, respectively [ 27 ]. The use of these methods is limited by their inaccessibility and existence of specific complications [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Successful One-and-a-Half Ventricle Repair of Right Ventricle Dysfunction Due to Lymphoblastic Leukemia Treatment in a Patient with Restrictive Cardiomyopathy

et al. 2021

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Patient: Female, 29-year-old Final Diagnosis: Restrictive cardiomyopathy with isolated endomyocardial fibrosis of the right ventricle • tricuspid valve insufficiency Symptoms: Reduced exercise tolerance • dyspnea and heart rhythm disorders Medication: — Clinical Procedure: — Specialty: Cardiac Surgery • Cardiology Objective: Rare disease Background: The cardiotoxic effects of chemotherapy in cancer treatment can damage cardiomyocytes. A common link in the pathogenesis is the proliferation of fibroblasts and the increase of collagen synthesis, leading to development of common endomyocardial fibrosis. The walls of ventricles become rigid and their inability to relax prevents them from carrying the required amount of blood. The myocardial contractility gradually decreases and leads to ventricular dysfunction and signs of heart failure. Case Report: A 29-year-old woman with reduced exercise tolerance, dyspnea, and heart rhythm disorders was admitted to our hospital. Lymphoblastic leukemia had been diagnosed at the age of 8 years, and she underwent 8 courses of polychemotherapy. She had normal heart anatomy. At the current admission, the diagnostic protocol included echocardiography, computed tomography, cardiac catheterization, and angiocardiography. She was diagnosed with restrictive cardiomyopathy with isolated endomyocardial fibrosis of the right ventricle, and moderate tricuspid valve insufficiency NYHA class III. The patient underwent a right-sided bidirectional cavopulmonary connection with tricuspid valve repair. The early postoperative period was uneventful, and SVCp decreased to 14 mmHg. At discharge, the patient’s clinical condition had improved and tricuspid regurgitation was minimal. Conclusions: The one-and-a-half ventricular correction, commonly used in patients with Ebstein’s anomaly and RV dysfunction or in patients with congenital heart defects associated with RV hypoplasia, is proposed as the method of choice for cardiomyopathy type RV dysfunction.

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Tricuspid valve relocation with endomyocardial fibrosis removal for Löeffler’s endocarditis

Cited by 2 publications

References 3 publications

A case report of Löffler’s endocarditis with right ventricular outflow obstruction in idiopathic hypereosinophilic syndrome: timely surgical intervention is crucial

A case report of Löffler’s endocarditis with right ventricular outflow obstruction in idiopathic hypereosinophilic syndrome: timely surgical intervention is crucial

Successful One-and-a-Half Ventricle Repair of Right Ventricle Dysfunction Due to Lymphoblastic Leukemia Treatment in a Patient with Restrictive Cardiomyopathy

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