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

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          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.

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          Author and article information

          Journal
          Ther Clin Risk Manag
          Therapeutics and Clinical Risk Management
          Therapeutics and Clinical Risk Management
          Dove Medical Press
          1176-6336
          1178-203X
          2009
          2009
          4 June 2009
          : 5
          : 409-412
          Affiliations
          [1 ]Department of Cardiac Surgery,
          [2 ]Department of Radiology, University Hospital Grosshadern, Munich, Germany
          Author notes
          Correspondence: Andres Beiras-Fernandez, Department of Cardiac Surgery, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany, Tel +49 89 7097 5074, Fax +49 89 7097 1847, Email andres.beiras@ 123456med.uni-muenchen.de
          Article
          tcrm-5-409
          2695241
          19753134
          © 2009 Kur et al, publisher and licensee Dove Medical Press Ltd.

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

          Categories
          Case Report

          Medicine

          aortic valve replacement, aorta, risk analysis, surgery

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