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

• 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
• ISSN: 1341-1098; 2186-1005
• DOI: 10.5761/atcs.cr.10.01540

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.