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Minimizing cardiac surgery risks in a Hepatitis C patient: Changing surgical strategy after evaluation by modern imaging technologies

Authors Kur F, Beiras-Fernandez A, Oberhoffer M, Nikolaou K, Vicol C, Reichart B

Published 21 May 2009 Volume 2009:5 Pages 409—412

DOI https://doi.org/10.2147/TCRM.S5496

Review by Single-blind

Peer reviewer comments 3

Felix Kur1, Andres Beiras-Fernandez1, Martin Oberhoffer1, Konstantin Nikolaou2, Calin Vicol1, Bruno Reichart1

1Department of Cardiac Surgery, 2Department of Radiology, University Hospital Grosshadern, Munich, Germany

Abstract: Minimizing operative risks for the surgical team in infectious patients is crucial. We report on a patient suffering from Hepatitis C undergoing re-operative aortic valve and ascending aorta replacement for aortic aneurysm and paravalvular leakage due to recurrent endocarditis of a Smeloff–Cutter aortic ball prosthesis. Preoperative multi-slice computed tomography and real-time three-dimensional echocardiography proved helpful in changing operative strategy by detecting a previously unknown aortic aneurysm, assessing its extent, and demonstrating the close proximity of the right coronary artery, right ventricle, and the aortic aneurysm to the sternum. Thus, cardiopulmonary bypass was instituted via the femoral vessels, instead of conventionally. Location, morphology, and extent of the paravalvular defect could also be assessed.

Keywords: aortic valve replacement, aorta, surgery, risk analysis

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