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[Cardiovascular surgery with multiple myeloma].

H Ishii¹, K Nakamura, M Yano

¹Department of Surgery II , University of Miyazaki, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery

|May 10, 2012

Summary

Cardiovascular surgery in multiple myeloma patients presents challenges. Infection is a significant factor impacting prognosis, as illustrated by two sepsis-related deaths in three reported cases.

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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.