[Anesthesiologic management for lower pulmonary lobectomy intervention in patients with heart transplant. A clinical case].
The Authors describe the case of a patient who had undergone human allograft cardiac transplant seven months before inferior pulmonary lobectomy for neoplasia. The pulmonary neoplasia had been revealed by X-rays during the periodic check-up examinations. Because of the high risk of infection following corticosteroid and immunosuppressive therapy, sterile equipment for invasive monitoring and oro-tracheal intubation has been used. The denervated heart presents peculiar haemodynamic and pharmacological aspects that the anaesthetist must pay attention to in the conduction of a general anaesthesia; moreover, arrhythmias are common in the recently transplanted heart. Anaesthesia has been induced and maintained by an association propofol-fentanyl that showed a good cardiocirculatory stability; neither arrhythmias have happened, nor the need for drugs different from those of anaesthesia and resuscitation have occurred.
Domenegati
E
E
Ciccone
R
R
Reali
F
F
Reposi
C
C
De Amici
D
D
Rissotti
M
M
D000230:Adenocarcinoma / Q000601:surgery*; D000768:Anesthesia, General; D005283:Fentanyl; D016027:Heart Transplantation; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D015742:Propofol
D005283:Fentanyl; D015742:Propofol
Condotta anestesiologica per intervento di lobectomia polmonare inferiore in paziente cardiotrapiantato. Caso clinico.