| Japanese |
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| Title | 肥大型心筋症合併患者における経食道エコーの有用性 |
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| Subtitle | 症例 |
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| Authors | 内田桂子, 野村実, 三浦芳則, 杉野芳美, 野村ゆう子, 川真田美和子, 藤田昌雄 |
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| Organization | 東京女子医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 13 |
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| Number | 2 |
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| Page | 287-290 |
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| Year/Month | 1992/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」術前に肥大型心筋症(HCM)の疑いがあると診断された2症例の麻酔管理に経食道心エコー(TEE)を使用した. HCM合併患者の麻酔管理は心臓の被刺激性亢進による不整脈や心筋虚血の面から困難な場合が多い. TEEは比較的非侵襲的モニターであり, Bモードでの心筋収縮能の観察が容易であることに加え, パルスドプラ法により左室拡張能を経時的に評価することができ, HCM合併患者の麻酔管理に有用であると思われた. 「はじめに」近年, 心エコー検査の普及により, 肥大型心筋症(HCM)の疑いがある患者の麻酔管理を行なう機会は増加してきている. 今回, 我々は術前診断としてHCMの疑いがある2症例に, 経食道エコー(TEE)を用いて麻酔管理を行なったので, 若干の考察を加えて報告する. 「症例 1」38才男性, 身長176cm, 体重83kg. 既往歴として, 7才のとき両側鼠径ヘルニアの根治手術を受けている. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | hypertrophic cardiomyopathy, transesophageal echocardiography |
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| English |
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| Title | Usefulness of Transesophageal Echocardiography in Patients with Hypertrophic Cardiomyopathy |
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| Subtitle | |
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| Authors | Keiko Utida, Minoru Nomura, Yoshimi Sugino, Yoshinori Miura, Yuko Nomura, Miwako Kawamata, Masao Fujita |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology,Tokyo Women's Medical College |
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| Journal | Circulation Control |
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| Volume | 13 |
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| Number | 2 |
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| Page | 287-290 |
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| Year/Month | 1992/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We have managed 2 patients with idiopathic hypertrophic cardiomyopathy (HCM) undergoing general surgery. Both patients had severe myocardial wall thickning and mild or severe mitral regurgitation, and preoperative electrocardiography indicated myocardial ischemia. Anesthesia was induced fentanyl with diazepam and maintained with sevoflurane, nitrous oxide, and oxygen. Muscle relaxants included vecuronium 0.1 mg/kg at induction and additional dose was administered. TEE was performed with a biplane probe (ALOKA, Inc, Tokyo, Japan). One patient, 38 years old male, scheduled for removal of adrenal tumor due to primary aldostelonism. One hour after the operation started, an episode of segmental wall motion abnormalities (septum-posterior wall) was detected by TEE, but significant ST-T changes were absent. The other patient, 52 years old male with arteriosclerosis obliterans, showed variable changes of E and A wave ratio of transmitral flow, which suggested changes of diastolic function during the operation. We are able to control hemodynamics easily, adjusting inspired concentration of sevoflurane or infusing vasodilators, by observing TEE. We conclude that TEE is useful to manage patients with HCM during non-cardiac surgery. |
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| Practice | Basic medicine |
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| Keywords | hypertrophic cardiomyopathy, transesophageal echocardiography |
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