Aortic Valve Replacement in a Patient With Myelodysplastic Syndrome and Interstitial Pneumonia

Abstract

There are a few reports of cardiac surgery in patients with myelodysplastic syndrome (MDS). It is difficult to control bleeding and prevent infection in the presence of pancytopenia. Interstitial pneumonia, which is treated by steroid medication, is also a risk factor in cardiac surgery. Aortic valve replacement was successfully performed in a patient with severe thrombocytopenia associated with MDS, interstitial pneumonia and scleroderma.

To Spare or Not to Spare…? The Aortic Valve in Scleroderma and Aortic Root Aneurysm

“…Only a few patients underwent surgery for aortic valve replacement for stenosis in systemic sclerosis with no postoperative complications related to surgery . No cases of TAVI for aortic valve stenosis have been reported in scleroderma patients, but one report described a balloon valvuloplasty in a 80‐year‐old female for a severely calcified aortic valve.…”

Heart Valve Abnormalities in Systemic Sclerosis Patients

“…In Table 4, we summarized the main articles concerning valvular disease in SSc patients. On the whole, 21 articles were case reports 45–65 ; 11 were case series, 22,24–28,30–32,40,42 which often included few patients; and 3 studies were based on large cohorts 38,43,44 . Overall, we found 9 controlled studies 23,29,33–37,39,41 …”

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.…”