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[Surgical treatment of endocardial cushion defect in 3 elderly patients]
O Shigemitsu1, T Hadama, H Takasaki
1Second Department of Surgery, Oita Medical University, Japan.
Insights
Surgical repair of partial endocardial cushion defects (ECD) is effective in patients over fifty. Careful perioperative management is crucial for successful outcomes in elderly individuals undergoing this cardiac surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Adult Congenital Heart Disease
Background:
- Partial endocardial cushion defects (ECD) are congenital heart abnormalities.
- Surgical intervention is considered for symptomatic cases.
- Outcomes in elderly patients undergoing ECD repair are less documented.
Observation:
- Three patients aged 55-59 underwent surgical repair for partial ECD.
- Comorbidities included tricuspid regurgitation (TR) and mitral regurgitation (MR).
- One patient required mitral cleft repair and experienced postoperative mediastinitis.
Findings:
- All three elderly patients survived the surgical procedure.
- Postoperative assessments showed decreased cardiothoracic ratio (CTR).
- All patients demonstrated improved New York Heart Association (NYHA) functional classification.
Implications:
- Surgical repair of partial ECD is a viable option for select elderly patients.
- Meticulous perioperative fluid and respiratory management is essential.
- This approach can lead to improved cardiac function and quality of life in older adults.
Abstract:
We performed surgical treatment for partial endocardial cushion defect in 3 patients over fifty year old. Case 1 was a 55-year-old-male with TR of grade II. Case 2 was a 59-year-old-female with TR and MR, and was repaired mitral cleft by a mattress suture. She needed infusion of dopamine (over 5 micrograms/kg/min) for 6 days and therapy of mediastinitis postoperatively. Case 3 was 56-year-old-male without atrioventricular valve regurgitation. Preoperative left ventricular volume was small in all patients, therefore perioperative circulatory control, mainly water balance, and respiratory control were importance. All patients survived, and both decreasing of CTR and improvement of NYHA classification were recognized in all three patients. In conclusion the operation for ECD in even elder patients was effective, but intensive care needed perioperatively.