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Minimally invasive cardiac surgery in a patient with osteopetrosis and symptomatic mitral regurgitation

Takanori Kono1, Kazuyoshi Takagi1, Eiki Tayama1

  • 1Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.

Journal of Cardiac Surgery
|December 7, 2020
PubMed

Insights

This case report details a successful minimally invasive cardiac surgery for severe mitral regurgitation in a patient with osteopetrosis, a rare bone disorder. The procedure highlights a viable surgical option for complex cardiac conditions in osteopetrosis patients.

Area of Science:

  • Cardiology
  • Genetics
  • Surgical Innovation

Background:

  • Osteopetrosis is a rare genetic bone disorder characterized by osteoclast dysfunction and increased bone density.
  • Cardiovascular complications in osteopetrosis are not well-documented, and surgical outcomes, particularly sternotomy, remain unclear.
  • Severe mitral regurgitation presents a significant challenge, especially in patients with underlying skeletal abnormalities.

Observation:

  • A 63-year-old woman with osteopetrosis presented with exertional dyspnea and severe mitral regurgitation.
  • Transthoracic echocardiography confirmed severe mitral regurgitation due to posterior leaflet prolapse.
  • Radiological imaging revealed characteristic increased bone density consistent with osteopetrosis.

Findings:

  • Median sternotomy poses potential risks in osteopetrosis patients due to altered bone structure.
  • Minimally invasive cardiac surgery via right minithoracotomy was successfully performed for mitral valve repair.
  • The surgery provided adequate visualization despite sclerotic rib changes, with no residual mitral regurgitation observed postoperatively.

Implications:

  • Minimally invasive cardiac surgery is a feasible and potentially safer alternative to sternotomy for mitral regurgitation in osteopetrosis patients.
  • This case expands the understanding of surgical management options for cardiovascular disease in rare bone disorders.
  • Further research is warranted to establish best practices for cardiac surgery in osteopetrosis patients.

Keywords:
minimally invasive cardiac surgerymitral regurgitationosteopetrosis

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