[The use of PGE1 in an elderly patient with mitral valve regurgitation during general anesthesia].
PGE1 has a beneficial effect on cardiac failure with mitral valve regurgitation by decreasing the "after load". An 82-year-old female had a total cystectomy of a bladder tumor. The preoperative standard 12 lead electrocardiogram showed atrial fibrillation and incomplete right bundle branch block. The preoperative echocardiogram showed regurgitation of both mitral valve and tricuspid valve. Under heavy premedication, we intubated with fentanyl and pancuronium bromide, maintained anesthesia with enflurane. After incision, both pulmonary artery pressure and pulmonary capillary wedge pressure increased, and cardiac index decreased. Continuous injection of 100ng.kg-1.min-1 PGE1 made pulmonary artery pressure and pulmonary capillary wedge pressure to decrease, and cardiac index to increase. PaO2, however, decreased apparently. PGE1 was effective for cardiac failure with mitral valve regurgitation associated with pulmonary hypertension. But attention must be given to the decrease in PaO2.
Hirose
M
M
Sakai
K
K
Saitoh
A
A
Nakagawa
H
H
Tanaka
M
M
Yoda
K
K
D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000627:therapeutic use*; D000768:Anesthesia, General; D002302:Cardiac Output / Q000187:drug effects*; D003864:Depression, Chemical; D005260:Female; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects*; D013268:Stimulation, Chemical
D000527:Alprostadil