Anesthetic management in an adult moyamoya disease patient undergoing mitral valve plasty for severe mitral regurgitation

JA Clinical Reports
Kazutomo SaitoMasanori Yamauchi

Abstract

Despite several previous reports, there are no established procedures for intraoperative management in moyamoya disease patients requiring cardiac surgery. Herein, we report the case of a 42-year-old man who was scheduled to undergo mitral valve plasty for severe mitral regurgitation. He had been diagnosed with moyamoya disease on the onset of cerebral ischemia at 41 years of age. During the cardiac surgical procedure, the patient was maintained on inhalation anesthesia with 1 to 1.5 % sevoflurane. Sevoflurane causes cerebral vasodilation followed by increased cerebral blood flow, and moreover we expected a sevoflurane preconditioning-induced neuroprotective effect. In addition, we used pulsatile perfusion support to maintain cerebral circulation with intra-aortic balloon pumping during the cardiopulmonary bypass. We aimed to keep the mean arterial pressure constantly above 70 mmHg. We were able to maintain regional cerebral oxygen saturation at 80 % of the baseline value, and could not detect the progression of neurological deficits using follow-up brain single photon emission computed tomography. The patient was discharged 16 days after admission. The details of the clinical course of his case will add to our knowledge regard...Continue Reading

References

Feb 9, 2008·Interactive Cardiovascular and Thoracic Surgery·Ichiro KashimaRyuichi Takahashi
Jan 3, 2012·Journal of Cardiothoracic and Vascular Anesthesia·Pieter De BuysscherStefan De Hert

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BETA
sedation
coronary artery bypass

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INVOS®

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