title: Transient cardiac arrest in patient with left ventricular noncompaction (spongiform cardiomyopathy).
abstract: Left ventricular noncompaction (LVNC), also known as spongiform cardiomyopathy, is a severe disease that has not previously been discussed with respect to general anesthesia. We treated a child with LVNC who experienced cardiac arrest. Dental treatment under general anesthesia was scheduled because the patient had a risk of endocarditis due to dental caries along with a history of being uncooperative for dental care. During sevoflurane induction, severe hypotension and laryngospasm resulted in cardiac arrest. Basic life support (cardiopulmonary resuscitation) was initiated to resuscitate the child, and his cardiorespiratory condition improved. Thereafter, an opioid-based anesthetic was performed, and recovery was smooth. In LVNC, opioid-based anesthesia is suggested to avoid the significant cardiac suppression seen with a volatile anesthetic, once intravenous access is established. Additionally, all operating room staff should master Advanced Cardiac Life Support/Pediatric Advanced Life Support (including intraosseous access), and more than 1 anesthesiologist should be present to induce general anesthesia, if possible, for this high-risk patient.
authors.affiliation: Department of Dental Anesthesiology, Ohu University School of Dentistry, Koriyama, Fukushima, Japan. zakiyama@ops.dti.ne.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawaai
mesh_terms: D000766:Anesthesia, Dental / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D009202:Cardiomyopathies / Q000150:complications*; D016887:Cardiopulmonary Resuscitation; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D005283:Fentanyl / Q000008:administration & dosage; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007093:Imidazoles / Q000627:therapeutic use; D007826:Laryngismus / Q000209:etiology; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000009:adverse effects; D011728:Pyridones / Q000627:therapeutic use; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D002316:Cardiotonic Agents; D007093:Imidazoles; D008738:Methyl Ethers; D011728:Pyridones; D000077149:Sevoflurane; C059498:olprinone; D005283:Fentanyl