Okamoto Shusuke, Okada Takuya, Obata Norihiko, Yamane Yu, Masada Koichiro, Iseki Masahiko, Nagae Masaharu
Department of Anesthesiology and Pain Clinic, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiya-cho, Himeji, 670-8560, Japan.
Division of Anesthesiology, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Heliyon. 2023 Oct 20;9(11):e21278. doi: 10.1016/j.heliyon.2023.e21278. eCollection 2023 Nov.
We report a case involving anesthetic management of Stanford type B acute aortic dissection occurred during transcatheter aortic valve implantation (TAVI) under monitored anesthesia care (MAC) in a patient with aortic stenosis (AS). An 87-year-old woman was undergoing TAVI under MAC for severe AS. During the surgery, the patient suddenly moved possibly because of pain. This was followed by hemodynamic collapse. She was then transitioned to general anesthesia, and extracorporeal membrane oxygenation (ECMO) was initiated. Transesophageal echocardiography revealed a Stanford type B acute aortic dissection, which was safely managed perioperatively with appropriate interventions.
我们报告了一例在主动脉瓣狭窄（AS）患者的监测麻醉护理（MAC）下经导管主动脉瓣植入术（TAVI）期间发生的斯坦福B型急性主动脉夹层的麻醉管理病例。一名87岁女性因严重AS在MAC下接受TAVI。手术过程中，患者可能因疼痛突然移动，随后出现血流动力学崩溃。然后她转为全身麻醉，并启动了体外膜肺氧合（ECMO）。经食管超声心动图显示为斯坦福B型急性主动脉夹层，通过适当干预在围手术期得到了安全处理。
