[Successful management of nonocclusive mesenteric ischemia after aortic valve replacement;report of a case].
Non-occlusive mesenteric ischemia (NOMI) is a fatal complication after cardiovascular surgery, but early diagnosis is difficult because the clinical symptoms are not specific. We report a case of NOMI with successful management due to early diagnosis and treatment. A 78-year-old male complained of sudden abdominal pain after aortic valve replacement. NOMI was suspected because his laboratory work-up showed elevated serum transaminase, and computed tomography showed no mesenteric artery obstruction. We started a continuous intravenous infusion of prostaglandin E1, and performed emergency arterial angiography. Since angiography showed vasospasm of the mesenteric artery, we also started a continuous intra-arterial infusion of papaverine. Each vasodilator drug was started within a few hours after the onset of NOMI. His subsequent hospital course was uneventful, and he was discharged without enterectomy or fatal intestinal necrosis.
Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Tomohito
T
Kanzaki
Masaaki
M
Koide
Yoshifumi
Y
Kunii
Kazumasa
K
Watanabe
Takuya
T
Maeda
Takuya
T
Okamoto
D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents