[Anesthetic management of two patients with hypertrophic obstructive cardiomyopathy for percutaneous transluminal septal myocardial ablation]. Masui 2003 Jan;52(1):42-5
Date
03/14/2003Pubmed ID
12632619Scopus ID
2-s2.0-0037275764 (requires institutional sign-in at Scopus site)Abstract
We experienced anesthetic management of two patients with hypertrophic obstructive cardiomyopathy (HOCM) for percutaneous transluminal septal myocardial ablation (PTSMA). PTSMA had been performed more than a year earlier in both cases, and symptoms and exercise tolerance were improved after PTSMA. Laparotomy for suspected ovarian cancer in one patient and thoracotomy for metastatic lung cancer in the other patient were proposed. Preoperative echocardiography showed reduced left ventricular outflow tract pressure gradient (from 90 mmHg before PTSMA to 10 mmHg and from 81 mmHg to 17 mmHg, respectively) and decreased septal wall thickness. Systolic anterior movement of mitral valve apparatus had disappeared. General anesthesia in the former and general anesthesia combined with epidural anesthesia in the latter were employed. Anesthesia was induced with propofol and fentanyl. A laryngeal mask was used to minimize hemodynamic fluctuations during induction and emergence in the former. Anesthesia was maintained with propofol, sevoflurane and supplemental fentanyl. Epidural anesthesia was also used to maintain anesthesia in the latter. The postoperative course was uneventful in each case. PTSMA for HOCM might be useful to prevent perioperative cardiac events.
Author List
Kishi Y, Mizobuchi A, Kuri M, Baba M, Taniguchi H, Nakagawa M, Mammoto T, Kanbara N, Sakai TAuthor
Tadanori Mammoto MD, PhD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAnesthesia, Epidural
Anesthesia, General
Cardiomyopathy, Hypertrophic
Catheter Ablation
Female
Fentanyl
Humans
Laparotomy
Laryngeal Masks
Methyl Ethers
Propofol
Thoracotomy