title: [Anesthetic management for pneumonectomy in a patient with cardiac amyloidosis].
abstract: Cardiac amyloidosis may cause restrictive cardiomyopathy associated with heart failure, conduction disorder and ischemic heart disease. Therefore, patients with amyloidosis require careful hemodynamic monitoring in perioperative period. A 63-year-old man with cardiac amyloidosis was scheduled for pneumonectomy. His transthoracic echocardiography assessment showed a hypertrophic interventricular septum and slight decreased ejection fraction of 55%, but left ventricular (LV) diastolic function was decreased. Pulse Doppler for mitral valve inflow showed that the early peak velocity/atrial peak velocity (E/A) ratio was 0.9, the deceleration time (DT) was 163 msec and the early diastolic mitral annular tissue velocity (E') was 4 cm x sec(-1). These data suggested a pseudonormalization state. We performed careful monitoring using arterial pressure-based cardiac output (APCO), central venous oxygen saturation (ScvO2) and transesophageal echocardiography. There were no severe complications such as circulatory collapse and arrhythmia in the perioperative period.
authors.affiliation: Department of Anesthesiology, Hyogo College of Medicine, Nishinomiya 663-8501.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Tomita
authors.forename: Noriko
authors.initials: N
authors.lastname: Shimode
authors.forename: Hajime
authors.initials: H
authors.lastname: Nomura
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ueki
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Tatara
authors.forename: Chikara
authors.initials: C
authors.lastname: Tashiro
mesh_terms: D000686:Amyloidosis / Q000209:etiology* / Q000503:physiopathology; D000758:Anesthesia; D009202:Cardiomyopathies / Q000209:etiology* / Q000503:physiopathology; D017548:Echocardiography, Transesophageal; D006333:Heart Failure / Q000209:etiology; D006439:Hemodynamics; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009101:Multiple Myeloma / Q000150:complications; D019990:Perioperative Care; D011013:Pneumonectomy; D013906:Thoracoscopy