[Anesthetic management of patients with cardiomyopathies].
Anesthetic management of patients with cardiomyopathy was studied. In the past 8 years, we experienced 24 surgical procedures for 16 patients complicated with cardiomyopathy of whom 6 cases with hypertrophic type (HCM) and 10 cases with dilated type (DCM). In HCM there was no correlation between the incidence of intraoperative complication and preoperative evaluation by New York Heart Association. In HCM cases who revealed atrial fibrillation, conduction disturbance on ECG and hypokinesis on echocardiogram resulted in high incidence of cardiac complication during anesthesia. Induction of anesthesia is extremely risky if the anesthesiologist is not aware of the presence of cardiomyopathies. In DCM, preoperative episode of heart failure, arrhythmias and conduction disturbance on ECG were considered as anesthetic risk factors. Both in HCM and DCM, there were no statistical significance in complication between general anesthesia and epidural anesthesia. The authors recommend epidural technique as a method of choice for HCM patient.
Takenaka
T
T
Department of Anesthesiology, School of Medicine, Kitasato University, Sagamihara.
Nomiyama
S
S
Okada
S
S
Miyoshi
S
S
Murakami
M
M
Watanabe
S
S
Tanaka
R
R
D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013514:Surgical Procedures, Operative