[Dual atrioventricular nodal conduction and arrhythmia with severe hemodynamic alterations during liver retransplantation].
We report the case of a man who developed tachycardia caused by atrioventricular reentry related to dual nodal conduction during liver retransplantation. The hemodynamic alterations were severe. Arrhythmia and altered cardiac conduction are potential complications of liver transplantation. The development of tachyarrhythmias--atrial fibrillation as well as episodes of supraventricular and ventricular tachycardia and bradycardia--have been described. Such arrhythmias tend to occur particularly during reperfusion of the graft. Risk factors implicated are the severe ion imbalances, acid-base imbalance, and hypothermia that accompany the reperfusion of a new organ. A review of the possible pathogenic and etiological mechanisms that lead to arrhythmia in patients with end-stage liver disease is provided.
Zaballos
M
M
Servicio de Anestesiología y Reanimación. Hospital Universitario Gregorio Marañón. Madrid. alma@nacom.es
Jimeno
C
C
Jiménez
C
C
Fraile
J R
JR
Almendral
García de Lucas
E
E
D000137:Acid-Base Imbalance / Q000209:etiology; D001283:Atrioventricular Node / Q000503:physiopathology*; D002346:Carotid Sinus / Q000503:physiopathology; D003131:Combined Modality Therapy; D000077324:Crystalloid Solutions; D048909:Diabetes Complications / Q000503:physiopathology / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004298:Dopamine / Q000627:therapeutic use; D004573:Electrolytes / Q000627:therapeutic use; D017809:Fatal Outcome; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications / Q000503:physiopathology; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D007431:Intraoperative Complications / Q000209:etiology* / Q000503:physiopathology; D007552:Isotonic Solutions; D008104:Liver Cirrhosis, Alcoholic / Q000503:physiopathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009638:Norepinephrine / Q000627:therapeutic use; D010952:Plasma Substitutes / Q000627:therapeutic use; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D015427:Reperfusion Injury / Q000503:physiopathology; D013616:Tachycardia, Sinus / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
D000077324:Crystalloid Solutions; D004573:Electrolytes; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D004298:Dopamine; D009638:Norepinephrine