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心包积液导致二尖瓣收缩期前向运动伴左心室流出道梗阻的升主动脉夹层患者：病例报告

Left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve in patient with pericardial effusion caused by ascending aortic dissection -A case report-.

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2013 Jan;64(1):73-6. doi: 10.4097/kjae.2013.64.1.73. Epub 2013 Jan 21.

DOI:10.4097/kjae.2013.64.1.73
PMID:23372891
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3558655/
Abstract

Left ventricular outflow tract (LVOT) obstruction with systolic anterior motion (SAM) of mitral valve is not only limited to patients with hypertrophic cardiomyopathy. A diagnosis of LVOT obstruction with SAM is important because conventional inotropic support may potentially aggravate hemodynamic deterioration. We present a case of LVOT obstruction with SAM in a patient who underwent an emergent surgery for ascending aortic dissection with pericardial effusion. The patient showed refractory hypotension after standard pharmacologic interventions during induction of anesthesia. Transesophageal echocardiography (TEE) revealed LVOT obstruction with SAM and it was managed appropriately under the guidance of TEE. Intraoperative TEE can play an important role in diagnosis and management of LVOT obstruction with SAM caused by pericardial effusion.

摘要

左心室流出道（LVOT）梗阻伴二尖瓣收缩期前向运动（SAM）不仅限于肥厚型心肌病患者。诊断 LVOT 梗阻伴 SAM 很重要，因为常规正性肌力支持可能潜在地加重血流动力学恶化。我们报告了一例因升主动脉夹层伴心包积液而行急诊手术的患者的 LVOT 梗阻伴 SAM。该患者在麻醉诱导期间进行标准药物干预后表现出难治性低血压。经食管超声心动图（TEE）显示 LVOT 梗阻伴 SAM，并在 TEE 指导下进行了适当的处理。术中 TEE 在诊断和处理心包积液引起的 LVOT 梗阻伴 SAM 中起着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8650/3558655/533b7ffd3c3f/kjae-64-73-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8650/3558655/a241b9fb3674/kjae-64-73-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8650/3558655/533b7ffd3c3f/kjae-64-73-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8650/3558655/a241b9fb3674/kjae-64-73-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8650/3558655/533b7ffd3c3f/kjae-64-73-g002.jpg

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