遗传性血管性水肿患者不停跳冠状动脉旁路移植术的围手术期处理。

Perioperative management of a patient with hereditary angioedema during off-pump coronary artery bypass graft surgery.

机构信息

Department of Anesthesiology, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA.

出版信息

J Clin Anesth. 2010 Jun;22(4):282-4. doi: 10.1016/j.jclinane.2009.04.007.

DOI:10.1016/j.jclinane.2009.04.007

PMID:20522360

Abstract

The case of a patient with hereditary angioedema (HAE), a rare, life-threatening disorder caused by reduced activity of the C1 esterase inhibitor, and requiring off-pump coronary artery bypass graft (OP-CABG) surgery, is presented. Perioperative management of patients with HAE who undergo complex cardiac surgical procedures are discussed, including an OP-CABG surgical approach to decrease complement activation, fresh-frozen plasma administration to increase C1 esterase inhibitor activity, and administration of reduced doses of heparin and protamine to minimize heparin-protamine complex formation.

摘要

现介绍一例遗传性血管性水肿（HAE）患者的病例。HAE 是一种罕见的、危及生命的疾病，由 C1 酯酶抑制剂活性降低引起，需要进行非体外循环冠状动脉旁路移植术（OP-CABG）。讨论了接受复杂心脏外科手术的 HAE 患者的围手术期管理，包括采用 OP-CABG 手术方法减少补体激活、给予新鲜冷冻血浆以增加 C1 酯酶抑制剂活性，以及给予低剂量肝素和鱼精蛋白以最小化肝素-鱼精蛋白复合物的形成。