Awake heart valve surgery in a patient with severe pulmonary disease.
Cardiac operations may be performed in a conscious, spontaneously breathing patient, but it is difficult to justify an awake technique in patients undergoing coronary artery procedures with low operative risk. We describe an elderly patient with severe chronic obstructive pulmonary disease in whom general anesthesia was contraindicated. A valve procedure was performed under thoracic epidural anesthesia alone, thus avoiding intubation and mechanical ventilation. The patient had an uneventful postoperative course and excellent recovery.
Knapik
Piotr
P
Silesian Center for Heart Diseases, Zabrze, Poland. pknapik@slam.katowice.pl
Przybylski
Roman
R
Nadziakiewicz
Paweł
P
Zembala
Marian
M
D000368:Aged; D000767:Anesthesia, Epidural / Q000379:methods*; D000768:Anesthesia, General; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery; D000075202:Contraindications; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome