Mitral Valve Repair via a Right Mini Thoracotomy in a Patient with Aplastic Anemia
10.4326/jjcvs.44.342
- VernacularTitle:再生不良性貧血を合併した僧帽弁閉鎖不全症に対し右小開胸による僧帽弁形成術を行った1例
- Author:
Shigeto Miyasaka
;
Keisuke Morimoto
;
Yoshikazu Fujiwara
;
Futoshi Kobayashi
- Publication Type:Journal Article
- Keywords:
aplastic anemia;
mitral valve insufficiency;
right lateral minithoracotomy
- From:Japanese Journal of Cardiovascular Surgery
2015;44(6):342-345
- CountryJapan
- Language:Japanese
-
Abstract:
Aplastic anemia is a syndrome characterized by pancytopenia, and performing an open heart operation for patients with this syndrome may be associated with an increased surgical risk for both bleeding and post-surgical infection. We report a case of mitral regurgitation complicated with aplastic anemia that underwent a mitral valve repair via a right lateral minithoracotomy. The patient was a 70-year-old woman who presented with shortness of breath on exertion. She was found to have aplastic anemia based on pancytopenia (WBC 2,150/µl, Hgb 8.8 g/dl, PLT 5.0×104/µl) and the results of a bone marrow biopsy. Echocardiography showed severe mitral valve insufficiency at the same time, and the patient was referred for surgery. To deal with the decrease in white blood cells and platelets, prior to surgery, a granulocyte colony-stimulating factor was administered, 30 units of platelet concentrate were transfused during the operation, and mitral valve repair via a right lateral minithoracotomy was performed. After surgery, there were no complications due to infection or bleeding, and the subsequent course was favorable. Several studies have reported the advantages in right minithoracotomy of less intraoperative bleeding and a lower infection rate compared with full sternotomy. In cases of this kind, in which there is a tendency toward bleeding and ease of infection, we believe that right lateral minithoracotomy may be a useful option to consider.
