Hemicolectomy in a patient with aortic valve disease: Case report
详细信息 查看全文
- 作者：Marí ; a Á ; ngeles Rodrí ; guez-Navarro ; marodrigueznavarro@yahoo.es ; Daniel Rastrollo-Peñ ; a ; Juan Iranzo-Reverter ; José ; Luis Sá ; nchez-Ortega ; Rosario Garcí ; a-Ferná ; ndez ; Clara Dí ; az-Alejo
- 关键词：Colectomy ; Anesthesia ; Monitoring ; intraoperative ; Aortic valve ; Heart diseases
- 刊名：Colombian Journal of Anesthesiology
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：45
- 期：supp_S1
- 页码：36-39
- 全文大小：628 K
- 卷排序：45
文摘
Patients with valve disease are at a higher risk of perioperative complications in the context of non-cardiac surgery. The active involvement of the anaesthetist from the moment of the pre-anaesthesia assessment to determine the severity of the disease is crucial.The purpose of this report on the management of a clinical case is to highlight the need for a multidisciplinary approach to the patient with heart disease.We present the case of a patient in the eighth decade of life with severe aortic stenosis, and a 46 mm infra-renal abdominal aortic aneurysm; chronic obstructive pulmonary disease, controlled arterial hypertension; and a lymphoproliferative process. Following the pre-anaesthesia assessment, valve repair surgery was indicated prior to a surgical procedure for colon cancer resection. Key to the successful management of this patient was pre-operative optimization with cardiac surgery and adjustment of the pharmacological treatment, plus haemodynamic monitoring as a basis for decision-making during the perioperative period using a minimally invasive device (Vigileo®). Spinal analgesia with intrathecal morphine was combined with general anaesthesia. The patient remained stable with CI 2.3–3 l/min/m2, SVV 2–7% and ScvO2 74–67%.As a result of the successful anaesthetic and surgical process, we concluded that it is our duty at the present time to know and apply the recommendations contained in the guidelines developed by the anaesthesia and cardiology societies and their regular updates, as they allow clinicians to make decisions in accordance with evidence-based protocols.