[Anesthetic management of a patient with HOCM even after PTSMA].
A 74-year-old woman previously treated with percutaneous transluminnal septal myocardial ablation (PTSMA) for severe hypertrophic obstructive cardiomyopathy (HOCM) underwent laparoscopic cholecystectomy under general anesthesia. The PTSMA was performed for HOCM 5 month before surgery and the left ventricular outflow pressure gradient (LVOTG) was reduced from 100 mmHg to 30 mmHg. After anesthetic induction, severe hypotension occurred concomitantly with asymmetrical septal hypertrophy (ASH) and systolic anterior movement of the mitral valve leaflet (SAM). Hypotension was treated with fluid therapy and the vasopressors (methoxamine and noradrenaline). Care should be taken for the anesthetic management of a patient with HOCM even after PTSMA.
Fujimoto
Hiroko
H
Division of Anesthesia, Isehara Kyodo Hospital, Isehara 259-1132.
Kamiya
Yoshinori
Y
Ohki
Hiroshi
H
Goto
Takahisa
T
D000368:Aged; D000768:Anesthesia, General; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery; D006346:Heart Septum; D006801:Humans; D012720:Severity of Illness Index