Difficult Anesthesia Management in a Case of Living Donor Liver Transplantation with Hypertrophic Obstructive Cardiomyopathy

Kondo Takashi

Kusunoki Shinji

Kuroda Masahiko

Kawamoto Masashi

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

Liver transplantation with hypertrophic obstructive cardiomyopathy is associated with acute hemodynamic changes, which can exacerbate left ventricular outflow tract obstruction during surgery. Therefore, selection of general anesthetic agents is important, as most can result in hemodynamic instability by reducing systemic vascular resistance and blood pressure. We report successful anesthetic management in a case of living donor liver transplantation with hypertrophic obstructive cardiomyopathy using ketamine, propofol, and fentanyl to avoid vasodilation by anesthetic agents. In addition, landiolol, phenylephrine, and low-dose dopamine were administered to prevent left ventricular outflow tract obstruction, and were found to be effective for improving acute hemodynamic changes during surgery. In the case of this patient, the combination of transesophageal echocardiography and a pulmonary artery catheter was beneficial for intraoperative hemodynamic monitoring.

Liver transplantation

Hypertrophic obstructive cardiomyopathy

General anesthesia

医学 [ 490 ]

英語

Hiroshima University Medical Press

(c) Hiroshima University Medical Press.

[ISSN] 0018-2052

[NCID] AA00664312