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

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),...

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Bibliographic Details
Published in:Annals of Thoracic and Cardiovascular Surgery 2011/06/25, Vol.17(3), pp.316-319
Main Authors: Minami, Hiroya, Asada, Tatsuro, Gan, Kunio, Yamada, Akitoshi, Sato, Masanobu
Format: Article
Language:English
Subjects:
Aged
Aortic Aneurysm, Thoracic - complications
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - surgery
Aortic Valve Insufficiency - complications
Aortic Valve Insufficiency - diagnostic imaging
Aortic Valve Insufficiency - surgery
aortic valve replacement
Aortography - methods
Blood Vessel Prosthesis Implantation - adverse effects
Circulatory Arrest, Deep Hypothermia Induced - adverse effects
deep hypothermic circulatory arrest
Duodenal Ulcer - etiology
Duodenal Ulcer - therapy
Female
Granulocyte Colony-Stimulating Factor - administration & dosage
heart surgery
Heart Valve Prosthesis Implantation - adverse effects
Humans
myelodysplastic syndrome
Myelodysplastic Syndromes - complications
Myelodysplastic Syndromes - therapy
Platelet Transfusion
Severity of Illness Index
Subarachnoid Hemorrhage - etiology
Subarachnoid Hemorrhage - therapy
thoracic aortic aneurysm
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography
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Summary: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.
ISSN:1341-1098
2186-1005
DOI:10.5761/atcs.cr.10.01540