[A case report of perioperative management for liver transplantation in a patient with multiple old myocardial infarction].
A 60-years-old (85 kg, 178 cm) coronary arterial disease patient having had acute myocardial infarction for several times received liver transplantation successfully. He had a previous episode of acute myocardial infarction associated with entire obstruction of right coronary 6 years ago, and was inserted a bracket then. One year ago the patient got chest pain again, and was diagnosed as inferior wall myocardial infarction. Then he received expectant treatment in internal medical department for several days. A 774HF75 PAC catheter (Edwards Lifescience, USA) was inserted into an internal jugular vein, and cardiac output, right ventricular end diastolic volume index, right ventricular ejection fraction, stroke volume index, system vascular resistance, pulmonary vascular resistance, left ventricular-stroke work index and right ventricular-stroke work index were calculated. During the operation, cardiovascular medications such as dopamine, norepinephrine, dobutamine were infused and adjusted by steps carefully. Electrolytes and acid-base balance were maintained normal. With these hemodynamic parameters, BGA and systemic management, the anesthesia was managed safely and successfully.
Department of Anaesthesia, Peking University People's Hospital, Beijing 100044, China.
Lei
L
Zhao
Tian-long
TL
Wang
D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D019990:Perioperative Care; D012008:Recurrence