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Perioperative Endocarditis Management in a Patient with Homozygous Sickle Cell Disease


Gozdzik, Malgorzata; Mariotti, Sergio; Genoni, Michele; Zientara, Alicja (2019). Perioperative Endocarditis Management in a Patient with Homozygous Sickle Cell Disease. Thoracic and Cardiovascular Surgeon Reports, 8(1):e1-e4.

Abstract

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.

Abstract

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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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:cardiopulmonary Bypass endocarditis hemofiltration sickle cell disease sickle crisis
Language:English
Date:January 2019
Deposited On:14 Mar 2019 11:59
Last Modified:01 Apr 2019 10:53
Publisher:Georg Thieme Verlag
ISSN:2194-7635
OA Status:Green
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1055/s-0038-1676962
PubMed ID:30648104

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