Matsumoto T, Kitano S, Yoshida T, Sato K, Bandoh T, Ninomiya K, Baatar D, Hadama T
Department of Surgery I, Oita Medical University, Japan.
Hepatogastroenterology. 1998 Sep-Oct;45(23):1476-8.
We present a case report of a patient with impaired cardiac function after aortic valve replacement and open mitral commissurotomy who underwent a laparoscopic cholecystectomy for cholecystolithiasis. In preventing reduced cardiac output due to pneumoperitoneum, the laparoscopic operative procedure was performed using the abdominal wall lift. Cardiac function was continuously evaluated by transesophageal echocardiographic examination and remained stable during the surgery. Because of the patient's co-existing chronic atrial fibrillation and prosthetic aortic valve, perioperative anticoagulation management was carried out. The patient's post-operative course was uneventful, and he was discharged on the 7th post-operative day.
我们报告一例主动脉瓣置换术和开放性二尖瓣交界切开术后出现心功能受损的患者，该患者因胆囊结石接受了腹腔镜胆囊切除术。为防止气腹导致心输出量减少，采用腹壁提升法进行腹腔镜手术操作。术中通过经食管超声心动图检查持续评估心功能，心功能在手术期间保持稳定。由于患者并存慢性心房颤动和人工主动脉瓣，因此进行了围手术期抗凝管理。患者术后恢复顺利，术后第7天出院。
