[Patient with right ventricular arrhythmogenic dysplasia, ascites and ulcerative colitis: anesthetic management during major abdominal surgery].
A 43-year-old man with ulcerative colitis was scheduled for pancolectomy owing to adenomatous transformation of polyps. The patient had right ventricular arrhythmogenic dysplasia, with deteriorating ventricular function, and carried an automatic implantable defibrillator. We discuss the general features of arrhythmogenic right ventricular dysplasia and its implications for management and monitoring during major abdominal surgery. Perioperative management of a patient with an implantable defibrillator is also discussed, with special attention to the influence of electromagnetic interference that can affect how the device functions during surgery. Finally, we list signs that should lead to suspicion of arrhythmogenic right ventricular dysplasia in an asymptomatic patient.
Martínez Torrente
F
F
Servicio de Anestesiología y Reanimación, Hospital Universitario, Madrid. francisco_martinez@medscape.com
Orts Castro
A
A
García-Montoto
F
F
Pérez-Cerdá
F
F
D018256:Adenomatous Polyps / Q000601:surgery; D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods; D000767:Anesthesia, Epidural / Q000379:methods*; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D001201:Ascites / Q000150:complications*; D001279:Atracurium / Q000031:analogs & derivatives; D017115:Catheter Ablation; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications*; D003110:Colonic Neoplasms / Q000601:surgery; D003111:Colonic Polyps / Q000601:surgery; D017147:Defibrillators, Implantable; D004868:Equipment Failure; D005283:Fentanyl; D006801:Humans; D007530:Isoflurane; D008297:Male; D016343:Monitoring, Intraoperative; D010149:Postoperative Pain / Q000188:drug therapy; D011182:Postoperative Care; D011183:Postoperative Complications / Q000601:surgery; D011229:Preanesthetic Medication; D012121:Respiration, Artificial; D013874:Thiopental
D001279:Atracurium; D007530:Isoflurane; D013874:Thiopental; C101584:cisatracurium; D005283:Fentanyl