Difficult Anesthesia Management in a Case of Living Donor Liver Transplantation with Hypertrophic Obstructive Cardiomyopathy
Hiroshima Journal of Medical Sciences Volume 62 Issue 4
Page 91-94
published_at 2013-12
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| File | |
| Title ( eng ) |
Difficult Anesthesia Management in a Case of Living Donor Liver Transplantation with Hypertrophic Obstructive Cardiomyopathy
|
| Creator |
Kuroda Masahiko
|
| Source Title |
Hiroshima Journal of Medical Sciences
|
| Volume | 62 |
| Issue | 4 |
| Start Page | 91 |
| End Page | 94 |
| Journal Identifire |
[PISSN] 0018-2052
[EISSN] 2433-7668
[NCID] AA00664312
|
| Abstract |
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.
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| Keywords |
Liver transplantation
Hypertrophic obstructive cardiomyopathy
General anesthesia
|
| NDC |
Medical sciences [ 490 ]
|
| Language |
eng
|
| Resource Type | departmental bulletin paper |
| Publisher |
Hiroshima University Medical Press
|
| Date of Issued | 2013-12 |
| Rights |
(c) Hiroshima University Medical Press.
|
| Publish Type | Version of Record |
| Access Rights | open access |
| Source Identifier |
[ISSN] 0018-2052
[NCID] AA00664312
|
