Uesugi Takanobu, Nishiyama Junji, Kimura Yoshie, Mori Miyako, Mikawa Katsuya, Obara Hidefumi
Department of Anesthesia & Perioperative Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017.
Masui. 2005 May;54(5):522-4.
Left ventricular noncompaction (LVNC) is a rare disease characterized by heart failure, arrhythmia, and embolic events. We report anesthetic management of a pregnant woman with LVNC. At 24 weeks gestation of the first pregnancy, the patient was scheduled for Cesarean section. Preoperatively the patient had symptomatic heart failure, and was anesthetized with propofol and fentanyl aiming at stable intraoperative hemodynamics. About 2 years later, the patient also underwent cesarean section under spinal anesthesia at 34 weeks gestation of the second pregnancy, because her cardiac function was almost normal and she was not receiving anticoagulant therapy. Both perioperative courses were uneventful. Careful preoperative assessment and close anesthetic planning are necessary.
左心室心肌致密化不全(LVNC)是一种罕见疾病,其特征为心力衰竭、心律失常和栓塞事件。我们报告一例患有LVNC的孕妇的麻醉管理情况。该患者首次怀孕,孕24周时计划行剖宫产术。术前患者有症状性心力衰竭,采用丙泊酚和芬太尼麻醉,目标是术中血流动力学稳定。约2年后,患者第二次怀孕,孕34周时因心功能基本正常且未接受抗凝治疗,在蛛网膜下腔麻醉下行剖宫产术。两次围手术期过程均顺利。术前仔细评估和精心的麻醉计划是必要的。