纯合子镰状细胞病患者围手术期心内膜炎的处理。

Malgorzata Gozdzik, Sergio Mariotti, Michele Genoni, Alicja Zientara
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引用次数: 3

摘要

纯合子镰状细胞病(SCD)合并细菌性心内膜炎使心内直视手术成为一个多学科的挑战。一例45岁非洲男性纯合子SCD患者,表现为右心失代偿、三尖瓣反流和主动脉瓣心内膜炎。血凝酶阴性葡萄球菌阳性。一个多学科的团队成功地完成了紧急双瓣膜置换术。结论纯合子SCD与术前血管闭塞并发症的风险增加有关。如果要避免低体温、缺氧、酸中毒或低流量,可以进行体外循环手术。由于缺乏数据,适当的方法仍然是直观的,需要标准化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Perioperative Endocarditis Management in a Patient with Homozygous Sickle Cell Disease.

Perioperative Endocarditis Management in a Patient with Homozygous Sickle Cell Disease.

Background  Homozygous sickle cell disease (SCD) compounded with bacterial endocarditis makes open-heart surgery a multidisciplinary challenge. Case description  A 45-year-old African male patient with homozygous SCD presented with right heart decompensation, tricuspid regurgitation, and endocarditis of the aortic valve. Blood coulters were positive for coagulase-negative staphylococci. An emergent double valve replacement was successfully performed involving a multidisciplinary team. Conclusion  Homozygous SCD is associated with an increased risk of preoperative vaso-occlusive complications. Surgery with cardiopulmonary bypass can be performed, if hypothermia, hypoxia, acidosis, or low-flows are being avoided. Due to the lack of data, the adequate approach is still intuitive and requires standardization.

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