Shimoyama Yuichiro, Sawai Toshiyuki, Nakahira Junko, Minami Toshiaki
Department of Anesthesiology, Osaka Medical College Hospital, Takatsuki 569-8686.
Masui. 2009 Feb;58(2):189-92.
We encountered a patient with atrial septal defect (ASD) of sinus venous type which had not been diagnosed preoperatively. A 70-year-old-man with angina pectoris was admitted to our hospital and coronary artery bypass grafting was scheduled. After induction of general anesthesia with fentanyl, propofol, midazolam, and vecuronium, operation was going smoothly. However, we found an abnormal rise of the value of Sv(O2). Transesophageal echocardiography (TEE) demonstrated ASD of sinous venous type which had not been diagnosed preoperatively. For this incidental diagnosis, operation was performed to repair ASD and was finished successfully. He was discharged from the hospital on postoperative day 18 without complications. We have demonstrated in this report that TEE is an important tool which should be used routinely to diagnose cardiac diseases which have not been diagnosed preoperatively.
我们遇到了一位患有静脉窦型房间隔缺损(ASD)的患者,术前未被诊断出来。一名患有心绞痛的70岁男性入住我院,计划进行冠状动脉搭桥术。在使用芬太尼、丙泊酚、咪达唑仑和维库溴铵诱导全身麻醉后,手术进展顺利。然而,我们发现Sv(O2)值异常升高。经食管超声心动图(TEE)显示为静脉窦型房间隔缺损,术前未被诊断出来。针对这一偶然发现的诊断,进行了手术修复房间隔缺损,手术成功完成。他在术后第18天出院,无并发症。我们在本报告中表明,TEE是一种重要的工具,应常规用于诊断术前未被诊断出的心脏疾病。