| Investigation of Mitral Valve
Replacement in a Patient with Mitral Valve Stenosis Who Complicated
with Myelodysplastic Syndrome and Left Atrial Thrombosis |
(Second Department of Surgery, School of Medicine,
Faculty of Medicine, University of the Ryukyus, Okinawa, Japan)
| Satoshi Yamashiro |
Yukio Kuniyoshi |
Kazufumi Miyagi |
| Mitsuyoshi Shimoji |
Toru Uezu |
Katsuya Arakaki |
| Katsuto Mabuni |
Shigenobu Senaha |
Kageharu Koja |
|
Patients with myelodysplastic syndrome
(MDS) most commonly have refractory anemia accompanied by various
degrees of granulocytopenia and thrombocytopenia. At the time
of cardiac surgery, both major infections and bleeding are severe
complications in patients with pancytopenia due to MDS. However,
there were very few patients with MDS who had undergone open-heart
surgery. We reported a case of mitral valve replacement in a
patient with MDS. A 68-year-old man with valvular heart disease
and MDS, with a platelet count of 1.9×104/mm3,
underwent successful mitral valve replacement. The mitral valve
was replaced by an SJM25A prosthesis after resection of left
atrial thrombosis using cardiopulmonary bypass. Platelets were
transfused after the bypass. Perioperative hemorrhage was moderate
and postoperative course was uneventful. We evaluated platelet
function by Sonoclot coagulation and a platelet function analyzer.
We did not need a large amount of transfusion of red blood cells
and platelets, and prevented major bleeding and severe wound
infections in the acute postoperative state.
Jpn. J. Cardiovasc. Surg. 31：418-421（2002) |
|
