Nakayama S, Inomata S, Furukawa H, Okubo N, Miyabe M, Toyooka H
Department of Anesthesiology, University of Tsukuba, Tsukuba 305-0006.
Masui. 2001 Feb;50(2):150-3.
We report the anesthetic management of patients with dilated cardiomyopathy who underwent left ventricular assist device implantation (LVAD). Anesthesia was induced and maintained with midazolam and fentanyl. Transesophageal echocardiography (TEE) and a PA catheter were useful for hemodynamic monitoring and management of the patients. Furthermore, TEE is useful for the early detection of inflow of the air which is absorbed by negative pressure derived from high LVAD support pressure. On starting LVAD support, evaluation of right ventricular function and treatment for right ventricular failure were important and necessary for the patients. Added to conventional therapy using catecholamines, inhaled nitric oxide may provide a favorable effect for right ventricular failure.
我们报告了接受左心室辅助装置植入（LVAD）的扩张型心肌病患者的麻醉管理情况。麻醉诱导和维持采用咪达唑仑和芬太尼。经食管超声心动图（TEE）和肺动脉导管有助于对患者进行血流动力学监测和管理。此外，TEE有助于早期发现因LVAD高支持压力产生的负压所吸收的空气进入情况。开始LVAD支持时，评估右心室功能和治疗右心室衰竭对患者而言非常重要且必要。除了使用儿茶酚胺的传统治疗方法外，吸入一氧化氮可能对右心室衰竭产生有益效果。
