Mitral Valve Replacement with Thymectomy in a Patient with Ocular Myasthenia Gravis: Case Report

  • Ovidiu Stiru Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
  • Mihai Stefan Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
  • Roxana Carmen Geana Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
  • Diana Sorostinean Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
  • Răzvan Radu Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
  • Daniela Filipescu Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
  • Ovidiu Chioncel Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
  • Vlad Anton Iliescu Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
Keywords: ocular myasthenia gravis, thymectomy, mitral valve replacement

Abstract

Patients diagnosed with ocular myasthenia gravis (MG) and mitral valve disease represent a significant perioperative management problem, especially for the anaesthesiologist, due to complex inter-actions between the disease, drugs to treat the disease, and anaesthetic agents, such as neuromuscu-lar blocking agents (NMBAs).

This paper describes the successful management of a 31-year-old female with mitral valve stenosis and ocular MG who was diagnosed with MG 4 years prior to the indication for cardiac surgery. Preoperatively, the patient was under treatment with Pyridostigmine and Prednisone. Mitral valve replacement and full thymectomy were performed, under general anaesthesia, using Fentanyl, Sevoflurane and low doses of non-depolarising NMBAs.

The postoperative course was uneventful, the patient was extubated at 6 hours postoperatively, in-tensive care unit stay was 48 hours, and the patient was discharged after 6 days without any compli-cations. After 3 months, at the follow-up examination, the patient’s ocular symptoms (eyelid ptosis) disappeared.

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Published
2019-08-28
How to Cite
Stiru, O., Stefan, M., Geana, R., Sorostinean, D., Radu, R., Filipescu, D., Chioncel, O., & Iliescu, V. (2019). Mitral Valve Replacement with Thymectomy in a Patient with Ocular Myasthenia Gravis: Case Report. The Heart Surgery Forum, 22(5), E340-E342. https://doi.org/10.1532/hsf.2627
Section
Articles