Anesthetic management for mitral valve replacement in a patient with mitral stenosis and dilated cardiomyopathy
Nakamura, T.; Ikeshita, K.; Shimizu, M.; Miyake, W.; Ikeda, Y.; Asada, A.
MASUI. Japanese Journal of Anesthesiology 60(2): 220-223
2011
ISSN/ISBN: 0021-4892 PMID: 21384662 Document Number: 649975
A 69-year-old man who has mitral stenosis concomitantly with dilated cardiomyopathy underwent mitral valve replacement. The preoperative left ventricular ejection fraction was 23%. Preoperative dobutamine stress echocardiography showed poor response. High dose fentanyl was administered for induction and maintenance of general anesthesia, and blood pressure was kept with vasoconstrictors. Circulatory assist with milrinone and intraaortic balloon pumping after the cardiopulmonary bypass enabled us to obtain stable hemodynamics.
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