Aortic Valve Replacement and Graft Replacement of the Ascending Aorta Using Deep Hypothermic Circulatory Arrest in a Patient with Myelodysplastic Syndrome

Abstract

A 73-year-old woman with a 10-year history of myelodysplastic syndrome (MDS) had severe aortic regurgitation (AR) and an ascending thoracic aortic aneurysm (TAA) with a maximum diameter of 55 mm. By retrograde cerebral perfusion (RCP) in the patient under deep hypothermic circulatory arrest (DHCA), we replaced the ascending aorta graft and aortic valve. After surgery, we periodically administered granulocyte colony-stimulating factor (GCSF) with platelet aggregation. On postoperative day 20, the patient had a duodenal ulcer. On postoperative day 22, she had a subarachnoid hemorrhage, which was treated, nonoperatively, with a hemostatic agent. On postoperative day 126, she was discharged without sequelae, and 1.5 years after the surgery, she has had neither heart failure nor deterioration of MDS.

Transfemoral balloon expandable aortic valve implantation in a patient with myelodysplastic syndrome

“…5,7 The literature contains very few case presentations on the performance of aortic valve surgery on patients with myelodysplastic syndrome while there are no publications on the use of the TAVI method on these cases. 5…”

“…4 Based on a comprehensive investigation of the literature, we found that only about 10 cases of heart surgery in patients with MDS have been reported previously and most of them were operated on due to an isolated CABG or a single valve replacement. 5,7 The literature contains very few case presentations on the performance of aortic valve surgery on patients with myelodysplastic syndrome while there are no publications on the use of the TAVI method on these cases. 5 As a treatment method that gives hope to patients with severe aortic stenosis who are under high surgical risk, transcatheter aortic valve implantation has been increasingly used, with an extending range of indications.…”

“…5,7 The literature contains very few case presentations on the performance of aortic valve surgery on patients with myelodysplastic syndrome while there are no publications on the use of the TAVI method on these cases. 5 As a treatment method that gives hope to patients with severe aortic stenosis who are under high surgical risk, transcatheter aortic valve implantation has been increasingly used, with an extending range of indications. 6 With this interventional treatment that forms an alternative to surgery, many patients benefit from the treatment without a high incidence of surgical morbidity and mortality.…”

“…Perfusion 28 (5) prior to the procedure. Intervention by employing the percutaneous technique through the use of the 14F Prostar XL (Prostar™ XL14Fr; Abbott Vascular, Abbott Park, IL, USA) closing device instead of the surgical cutdown method on the intervention area on the patient's groin was decided.…”