title: Aortic valve replacement and graft replacement of the ascending aorta using deep hypothermic circulatory arrest in a patient with myelodysplastic syndrome.
abstract: A 73-year-old woman with a 10-year history of myelodysplastic syndrome (MDS) had severe aortic regurgitation (AR) and an ascending thoracic aortic aneurysm (TAA) with a maximum diameter of 55 mm. By retrograde cerebral perfusion (RCP) in the patient under deep hypothermic circulatory arrest (DHCA), we replaced the ascending aorta graft and aortic valve. After surgery, we periodically administered granulocyte colony-stimulating factor (GCSF) with platelet aggregation. On postoperative day 20, the patient had a duodenal ulcer. On postoperative day 22, she had a subarachnoid hemorrhage, which was treated, nonoperatively, with a hemostatic agent. On postoperative day 126, she was discharged without sequelae, and 1.5 years after the surgery, she has had neither heart failure nor deterioration of MDS.
authors.affiliation: Department of Cardiovascular Surgery, Miki City Hospital, Miki, Hyogo, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Minami
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Asada
authors.forename: Kunio
authors.initials: K
authors.lastname: Gan
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Yamada
authors.forename: Masanobu
authors.initials: M
authors.lastname: Sato
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000009:adverse effects; D004381:Duodenal Ulcer / Q000209:etiology / Q000628:therapy; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000628:therapy; D017713:Platelet Transfusion; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D016179:Granulocyte Colony-Stimulating Factor