[Cardiovascular surgery with multiple myeloma]

Area of Science:

• Cardiovascular Surgery
• Hematology Oncology

Background:

• Multiple myeloma is a hematologic malignancy that can affect various organ systems, including the cardiovascular system.
• Cardiovascular surgery in patients with multiple myeloma is infrequently reported, posing unique management challenges.

Observation:

• This report details three cases of patients with multiple myeloma undergoing cardiovascular surgery.
• Case 1 involved off-pump coronary artery bypass grafting (OPCAB) in a hemodialytic patient, who succumbed to sepsis on postoperative day 72.
• Case 2, mitral valve replacement for mitral regurgitation, had an uneventful postoperative course.
• Case 3 involved aortic graft replacement for an aneurysm in a patient diagnosed with multiple myeloma postoperatively, who died from sepsis on postoperative day 99.

Findings:

• Outcomes of cardiovascular surgery in multiple myeloma patients can be variable.
• Infection, particularly sepsis, is a critical complication and a major factor influencing postoperative prognosis in this patient population.
• Intractable infections pose a significant threat to survival following these procedures.

Implications:

• These cases highlight the complex interplay between multiple myeloma and cardiovascular disease.
• Careful patient selection, perioperative management, and vigilant monitoring for infection are crucial for improving outcomes.
• Further research is warranted to establish optimal surgical and management strategies for multiple myeloma patients requiring cardiovascular interventions.