title: [Anesthesic management of thoracic aortic stent graft deployment using rapid ventricular pacing].
abstract: Controlled hypotension is useful for accurate deployment of an aortic endograft. We describe the use of rapid ventricular pacing during thoracic aortic stent graft deployment. Anesthesia was induced and maintained with intravenous propofol and remifentanil. A pulmonary artery catheter with pacing function was introduced, and rapid ventricular pacing was started before stent graft deployment. Pacing mode was VVI and pacing rate was 120-160 beats min(-1). Aortic pressure and flow decreased immediately and were maintained at low levels during surgical manipulation. After stopping rapid ventricular pacing, heart rate and aortic pressure recovered immediately. Rapid ventricular pacing was performed 4 times, and there were no complications such as entailed arrhythmia. With rapid ventricular pacing maneuver, which is thought to cause a rapid change in cardiac output, continuous cardiac output measurement can be a useful monitor. This procedure has advantages over pharmacologic or other methods of aortic pressure reduction. Rapid ventricular pacing is safe and effective during stent graft positioning and deployment.
authors: Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, Asahikawa 078-8510.
authors: Akio
authors: A
authors: Yamagishi
authors: Takayuki
authors: T
authors: Kunisawa
authors: Norifumi
authors: N
authors: Katsumi
authors: Michio
authors: M
authors: Nagashima
authors: Osamu
authors: O
authors: Takahata
authors: Hiroshi
authors: H
authors: Iwasaki
mesh_terms: D000368:Aged; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001013:Aorta, Thoracic; D017545:Aortic Aneurysm, Thoracic / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D019919:Prosthesis Implantation / Q000379:methods*; D000077208:Remifentanil; D015607:Stents
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol