[Anesthetic management for mitral valve replacement in a patient with mitral stenosis and dilated cardiomyopathy].
A 42-year-old man with dilated cardiomyopathy and rheumatic mitral stenosis underwent mitral valve replacement. Prior intravascular fluid administration and infusion of dopamine and dobutamine stabilized hemodynamics during the induction of anesthesia. High-dose fentanyl at pre-cardiopulmonary bypass period and circulatory assist with milrinone and intraaortic balloon pumping after the bypass enabled us to obtain stable hemodynamics. Preoperative dobutamine stress test provided us the effective information for circulatory management in this patient.
Department of Anesthesiology, Niigata University School of Medicine.
S
S
Kurokawa
H
H
Fujihara
T
T
Tobita
S
S
Fukuda
K
K
Shimoji
D000328:Adult; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000601:surgery; D004280:Dobutamine / Q000008:administration & dosage; D004298:Dopamine / Q000008:administration & dosage; D005283:Fentanyl; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D020105:Milrinone / Q000008:administration & dosage; D008943:Mitral Valve / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000601:surgery; D019990:Perioperative Care
D018686:Anesthetics, Intravenous; D004280:Dobutamine; D020105:Milrinone; D005283:Fentanyl; D004298:Dopamine