[Anesthetic management for pneumonectomy in a patient with cardiac amyloidosis]

Masui. 2010 Dec;59(12):1514-7.
[Article in Japanese]

Abstract

Cardiac amyloidosis may cause restrictive cardiomyopathy associated with heart failure, conduction disorder and ischemic heart disease. Therefore, patients with amyloidosis require careful hemodynamic monitoring in perioperative period. A 63-year-old man with cardiac amyloidosis was scheduled for pneumonectomy. His transthoracic echocardiography assessment showed a hypertrophic interventricular septum and slight decreased ejection fraction of 55%, but left ventricular (LV) diastolic function was decreased. Pulse Doppler for mitral valve inflow showed that the early peak velocity/atrial peak velocity (E/A) ratio was 0.9, the deceleration time (DT) was 163 msec and the early diastolic mitral annular tissue velocity (E') was 4 cm x sec(-1). These data suggested a pseudonormalization state. We performed careful monitoring using arterial pressure-based cardiac output (APCO), central venous oxygen saturation (ScvO2) and transesophageal echocardiography. There were no severe complications such as circulatory collapse and arrhythmia in the perioperative period.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Amyloidosis / etiology*
  • Amyloidosis / physiopathology
  • Anesthesia*
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / physiopathology
  • Echocardiography, Transesophageal
  • Heart Failure / etiology
  • Hemodynamics*
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Monitoring, Intraoperative*
  • Multiple Myeloma / complications
  • Perioperative Care
  • Pneumonectomy
  • Thoracoscopy