Anesthesia for repair of ventricular septal rupture after acute myocardial infarction.
A surgical patient with ventricular septal rupture after acute myocardial infarction is presented. The primary concern of general anesthesia was in the maintenance of systemic arterial pressure and reduction of afterload. General anesthesia was induced with a combination of fentanyl, ketamine, and propofol, which successfully suppressed fluctuations of hemodynamic variables associated with induction of anesthesia and tracheal intubation. Intravenous milrinone was used for inotropic support and reduction of systemic vascular resistance. The ventricular septal rupture was successfully repaired.
Iida
Ryoji
R
Department of Anesthesiology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, Itabashi-Ku, Tokyo 173-8610, Japan. ryoiida@med.nihon-u.ac.jp
Kajiwara
Keizo
K
Saeki
Shigeru
S
Ogawa
Setsuro
S
D000768:Anesthesia, General / Q000379:methods*; D006342:Heart Rupture, Post-Infarction / Q000503:physiopathology / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D014655:Vascular Resistance