CC BY-NC-ND 4.0 · THORAC CARDIOV SURG Reports 2019; 08(01): e1-e4
DOI: 10.1055/s-0038-1676962
Case Report: Cardiac
Georg Thieme Verlag KG Stuttgart · New York

Perioperative Endocarditis Management in a Patient with Homozygous Sickle Cell Disease

Malgorzata Gozdzik
1  Department of Anesthesiology, Stadtspital Triemli, Zurich, Switzerland
,
Sergio Mariotti
1  Department of Anesthesiology, Stadtspital Triemli, Zurich, Switzerland
,
Michele Genoni
2  Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland
,
Alicja Zientara
3  Department of Cardiac Surgery, Triemli Hospital, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

21 August 2018

16 November 2018

Publication Date:
08 January 2019 (online)

  

Abstract

Background Homozygous sickle cell disease (SCD) compounded with bacterial endocarditis makes open-heart surgery a multidisciplinary challenge.

Case description A 45-year-old African male patient with homozygous SCD presented with right heart decompensation, tricuspid regurgitation, and endocarditis of the aortic valve. Blood coulters were positive for coagulase-negative staphylococci. An emergent double valve replacement was successfully performed involving a multidisciplinary team.

Conclusion Homozygous SCD is associated with an increased risk of preoperative vaso-occlusive complications. Surgery with cardiopulmonary bypass can be performed, if hypothermia, hypoxia, acidosis, or low-flows are being avoided. Due to the lack of data, the adequate approach is still intuitive and requires standardization.