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Perioperative management of a patient with Chagas disease having mitral valve surgery

Robert S Leckie1, Steven Leckie, Feroze Mahmood

  • 1Division of Cardiac Anesthesia, Department of Anesthesia and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. rleckie@bidmc.harvard.edu

Journal of Clinical Anesthesia
|June 9, 2009
PubMed

Insights

Advanced Chagas disease can cause heart problems like dilated cardiomyopathy. Transesophageal echocardiography safely guided mitral valve surgery in a patient with this complex condition.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Chagas disease, caused by Trypanosoma cruzi, can lead to chronic cardiac complications.
  • Dilated cardiomyopathy and mitral regurgitation are significant manifestations of advanced Chagasic heart disease.
  • Esophageal dysfunction is a recognized, though less common, feature of Chagas disease.

Observation:

  • A patient with advanced Chagas disease presented with severe symptoms of heart failure.
  • The patient exhibited echocardiographic evidence of dilated cardiomyopathy and significant mitral regurgitation.
  • Despite potential concerns for esophageal involvement, the patient underwent surgical intervention.

Findings:

  • Mitral valve surgery was successfully performed to address the patient's severe mitral regurgitation.
  • Transesophageal echocardiography (TEE) was utilized as a safe and effective tool for intraoperative guidance.
  • The use of TEE was not complicated by the patient's Chagas disease status or potential esophageal involvement.

Implications:

  • This case demonstrates the feasibility and safety of transesophageal echocardiography in patients with advanced Chagas disease undergoing cardiac surgery.
  • It highlights the importance of a multidisciplinary approach in managing complex cardiac conditions associated with Chagas disease.
  • Further research may explore the specific risks and benefits of TEE in this patient population.

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