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Characterization of Sickling During Controlled Automated Deoxygenation with Oxygen Gradient Ektacytometry
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Perioperative Endocarditis Management in a Patient with Homozygous Sickle Cell Disease

Malgorzata Gozdzik1, Sergio Mariotti1, Michele Genoni2

  • 1Department of Anesthesiology, Stadtspital Triemli, Zurich, Switzerland.

The Thoracic and Cardiovascular Surgeon Reports
|January 17, 2019
PubMed

Insights

Patients with homozygous sickle cell disease (SCD) undergoing open-heart surgery face challenges. Successful double valve replacement was performed, highlighting the need for standardized surgical approaches in complex cases.

Area of Science:

  • Cardiology
  • Hematology
  • Surgical Sciences

Background:

  • Homozygous sickle cell disease (SCD) presents significant challenges for patients requiring open-heart surgery.
  • Bacterial endocarditis further complicates surgical management in SCD patients.

Observation:

  • A 45-year-old male with homozygous SCD presented with right heart decompensation, tricuspid regurgitation, and aortic valve endocarditis.
  • Blood cultures identified coagulase-negative staphylococci as the causative agent.

Findings:

  • An emergent double valve replacement was successfully completed by a multidisciplinary team.
  • Homozygous SCD is linked to a higher risk of preoperative vaso-occlusive complications.

Implications:

  • Cardiopulmonary bypass surgery is feasible in homozygous SCD patients when avoiding hypothermia, hypoxia, acidosis, and low-flow states.
  • Standardized protocols are needed for managing these complex surgical cases due to limited data.

Keywords:
cardiopulmonary bypassendocarditishemofiltrationsickle cell diseasesickle crisis

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