A man with severe dilated cardiomyopathy with implantable cardioverter-defibrillator who underwent sigmoidectomy
Iwamuro, K.; Hamada, Y.; Koitabashi, T.
Masui. Japanese Journal of Anesthesiology 59(9): 1194-1197
2010
ISSN/ISBN: 0021-4892 PMID: 20857681 Document Number: 642773
We report a man with severe dilated cardiomyopathy with an implantable cardioverter-defibrillator (ICD) who underwent sigmoidectomy. During the operation, the defibrillation function of the ICD has been stopped to prevent malfunction caused by electrocautery artifacts, and the electrodes of the external defibrillator were placed on the chest wall. Pulmonary artery catheter was inserted under X-ray imaging to prevent the interference between ICD leads and the catheter. Anesthesia was maintained with combined general and thoracic epidural anesthesia. In order to prevent the afterload increase, both milrinone and carperitide were administered. Fluid resuscitation was also performed to maintain circulating blood volume. As a result of the management, patient has not exhibited any heart failure.