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Case report
Terezia B. Andrasi
University of Marburg: Philipps-Universitat Marburg
Corresponding Author
License:
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Background: The timing for heart surgery following cerebral embolization after cardiac valve vegetation is vital to postoperative recovery being uneventful, additionally Covid-19 may negatively affect the outcome. Minimally invasive methods and upgraded surgical instruments maximize the benefits of surgery also in complex cardiac revision cases with substantial perioperative risk.
Case Presentation: A 68 y.o. patient, 10 years after previous sternotomy for OPCAB was referred to cardiac surgery on the 10th postoperative day after neurosurgical intervention with suspected mitral valve endocarditis. Mitral valve vegetation, tricuspid valve insufficiency and coronary stenosis were diagnosed and treated by minimally invasive revision cardiac surgery.
Conclusion: The present clinical case demonstrates for the first time that the minimally invasive approach via right anterior mini-thoracotomy can be safely used for concomitant complex mitral valve reconstruction, tricuspid valve repair and aorto-coronary bypass surgery, even as a revision procedure in the presence of florid endocarditis after recent neurosurgical intervention. The Covid-19 pandemic and prophylactic patient isolation slow down the efficacy of pulmonary weaning and mobilisation and prolong the need for ICU treatment, without adversely affecting long-term outcome.
Keywords
Minimally invasive video-assisted cardiac surgery, valve endocarditis, coronary revascularization, cerebral septic embolism, Covid-19
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CURRENT STATUS: Under Review
Version 1
Posted 26 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 14 Apr, 2021
Reviewer #5 agreed
On 09 Apr, 2021
Review #1 received
Received 05 Apr, 2021
Review #2 received
Received 05 Apr, 2021
Reviewer #2 agreed
On 04 Apr, 2021
Reviewer #3 agreed
On 04 Apr, 2021
Reviewer #4 agreed
On 04 Apr, 2021
Reviews received
Received 04 Apr, 2021
Reviewers invited
Invitations sent on 04 Apr, 2021
Reviewer #1 agreed
On 04 Apr, 2021
Editor assigned
On 24 Mar, 2021
Submission checks complete
On 24 Mar, 2021
Editor invited
On 24 Mar, 2021
First submitted
On 17 Mar, 2021
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This preprint is under consideration at Journal of Cardiothoracic Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case report
Terezia B. Andrasi
University of Marburg: Philipps-Universitat Marburg
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 26 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 14 Apr, 2021
Reviewer #5 agreed
On 09 Apr, 2021
Review #1 received
Received 05 Apr, 2021
Review #2 received
Received 05 Apr, 2021
Reviewer #2 agreed
On 04 Apr, 2021
Reviewer #3 agreed
On 04 Apr, 2021
Reviewer #4 agreed
On 04 Apr, 2021
Reviews received
Received 04 Apr, 2021
Reviewers invited
Invitations sent on 04 Apr, 2021
Reviewer #1 agreed
On 04 Apr, 2021
Editor assigned
On 24 Mar, 2021
Submission checks complete
On 24 Mar, 2021
Editor invited
On 24 Mar, 2021
First submitted
On 17 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The timing for heart surgery following cerebral embolization after cardiac valve vegetation is vital to postoperative recovery being uneventful, additionally Covid-19 may negatively affect the outcome. Minimally invasive methods and upgraded surgical instruments maximize the benefits of surgery also in complex cardiac revision cases with substantial perioperative risk.
Case Presentation: A 68 y.o. patient, 10 years after previous sternotomy for OPCAB was referred to cardiac surgery on the 10th postoperative day after neurosurgical intervention with suspected mitral valve endocarditis. Mitral valve vegetation, tricuspid valve insufficiency and coronary stenosis were diagnosed and treated by minimally invasive revision cardiac surgery.
Conclusion: The present clinical case demonstrates for the first time that the minimally invasive approach via right anterior mini-thoracotomy can be safely used for concomitant complex mitral valve reconstruction, tricuspid valve repair and aorto-coronary bypass surgery, even as a revision procedure in the presence of florid endocarditis after recent neurosurgical intervention. The Covid-19 pandemic and prophylactic patient isolation slow down the efficacy of pulmonary weaning and mobilisation and prolong the need for ICU treatment, without adversely affecting long-term outcome.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
This is a list of supplementary files associated with this preprint. Click to download.
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