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Ann Thorac Surg 1996;61:1841-1843
© 1996 The Society of Thoracic Surgeons

Case Report

Mitral Valve Reconstruction in Sickle Cell Disease

Francis D. Pagani, MD, PhD, Rocco J. Polito, BS, Steven F. Bolling, MD

Section of Thoracic Surgery, Department of Surgery, University of Michigan Hospitals, Ann Arbor, Michigan

Accepted for publication December 12, 1995.

As survival improves in patients with sickle cell anemia, the prospects of performing cardiac surgical procedures on older patients with this genetic defect increase. We describe the successful management of a 52-year-old patient with sickle cell disease (homozygous for hemoglobin S) and a history of multiple sickle crisis undergoing cardiopulmonary bypass for mitral valve repair. Preoperative partial exchange transfusion followed by total exchange transfusion at the time of operation was performed to reduce the level of hemoglobin S to 5.4% during bypass. Other management strategies included high-flow normothermic bypass with aortic cross-clamping, topical hypothermia, and cold crystalloid cardioplegia.




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