MITRAL AND TRICUSPID VALVULOPLASTY IN A PATIENT WITH MYEL-ODYSPLASTIC SYNDROME
Delfa Radić-Krišto, Inga Mandac Rogulj, Biljana Jelić-Puškarić, Helena Jerkić, Gordana Kaić, Anita Škrtić, Viktor Zatezalo
Myelodysplastic syndrome (MDS) is a clonal disease of mutated hematopoietic stem cells characterized by abnormal hematopoietic differentiation and dysplastic bone marrow changes. MDS usually tends to present with anemia, less often with neutropenia and thrombocytopenia of varying degrees. Cardiac surgery in MDS patients is a major challenge because neutropenia and thrombocytopenia are the leading causes of infection and bleeding during the procedure. There are only a few reports of cardiovascular surgery in patients with MDS. We are presenting a 66-year-old MDS patient with a successful reconstruction of the mitral and tricuspid heart valve. The patient presented in the Emergency department with weakness and dyspnea. Radiological workup verified 3rd stage heart failure. Severe mitral and tricuspid insufficiency was verified, after which the patient underwent cardiac surgery, and five years after the procedure has good quality of life. Through the multidisciplinary collaboration of cardiologists, hematologists and cardiac surgeons an operative reconstruction of mitral and tricuspid valve was successfully performed. This case indicates the need for multidisciplinary care for the specific and vulnerable group of MDS patients with cardiovascular comorbidities.
Anita Škrtić, Biljana Jelić Puškarić, Delfa Radić-Krišto, Gordana Kaić, Helena Jerkić, Inga Mandac Rogulj, Viktor Zatezalo