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10.5606/tgkdc.dergisi.2012.021
Successful mitral valve replacement for infective endocarditis in a patient with liver cirrhosis and acute renal failure
Necmettin Çolak, Yunus Nazlı, Mehmet Fatih Alpay, Ömer Çakır
Department of Cardiovascular Surgery, Medicine Faculty of Fatih University, Ankara
DOI : 10.5606/tgkdc.dergisi.2012.021
Patients with liver cirrhosis and acute renal failure are
considered high risk for open cardiac surgery under
cardiopulmonary bypass. A 58-year-old female patient with
severe mitral regurgitation due to bacterial endocarditis
associated with moderate liver cirrhosis was admitted to
our clinic for the treatment of acute pulmonary edema.
Preoperative hepatic function state was estimated as Child-
Pugh class B. Intravenous gentamicin and vancomycin were
initiated for the treatment of acute infective endocarditis.
During antimicrobial therapy, the patient developed druginduced
acute renal failure. We immediately performed
mitral valve replacement under cardiopulmonary bypass
due to progressive heart failure. The postoperative course
was problem-free and the patient was discharged. With
careful preoperative preparation and good perioperative
management, open heart surgery can be performed with
a positive outcome in acute infective endocarditis patients
with moderate liver cirrhosis and acute renal failure.
Keywords : Acute renal failure; cirrhosis; endocarditis; mitral valve replacement
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