[Anesthetic management for patients with compromised left ventricular function due to coronary artery disease in non-cardiac surgery].
BACKGROUND
As the number of patients suffering from coronary artery disease (CAD) increases, anesthetic management for these patients become more common than the past. But no established management strategies have been proven beneficial.


METHODS
We reviewed all anesthetic management records of seven patients with compromised LV function (EF<30% or FS<30%) for CAD in our hospital, who had undergone non-cardiac operations.


RESULTS
Three cases were brain surgeries and four cases were abdominal surgeries. In all cases, central venous catheters were placed before induction of general anesthesia. After inotropic agents were started through central venous catheters, patients went through induction with midazolam, fentanyl and propofol without any trouble. In three cases of abdominal surgeries, pulmonary artery catheters were placed. And in five cases, artery catheters were placed in the femoral arteries, so that, in case of cardiac shock, we could start IABP without delay. In one case, we experienced shock during operation, but without IABP, the patient recovered with pharmacological support. No patient died of cardiac cause during the hospital stay for the procedure.


CONCLUSIONS
We reported anesthetic management of seven patients with compromised left ventricular function for CAD in non-cardiac surgery. However, as the reports of anesthetic management in patients with compromised left ventricular function in non-cardiac surgery is few, further study will be required.
Arai
Fumio
F
Department of Anesthesiology, Osaka Police Hospital, Osaka 543-0035.
Kita
Takashi
T
Maki
Naritoshi
N
Sasaki
Shigeta
S
D000005:Abdomen / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods*; D006348:Cardiac Surgical Procedures; D003327:Coronary Disease / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000150:complications*