| Japanese |
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| Title | 心房細動に対し, Maze手術を施行した症例の麻酔経験 |
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| Subtitle | 症例 |
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| Authors | 藤井美江, 野村実, 近藤泉, 小高桂子, 白井希明, 鈴木英弘 |
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| Organization | 東京女子医科大学麻酔科学教室 |
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| Journal | 循環制御 |
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| Volume | 16 |
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| Number | 3 |
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| Page | 391-395 |
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| Year/Month | 1995/ |
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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」Maze手術は, 心房細動のリエントリー回路を切断する手術である. 心房細動, 僧帽弁狭窄兼逆流症, 大動脈弁逆流症と診断された44才, 男性に対し, Maze手術と僧帽弁, 大動脈弁置換術を施行した症例の麻酔を経験したので報告する. 麻酔はフェンタニール, ジアゼパムにより導入し, フェンタニールで維持した. 体外循環離脱時は左室機能低下が認められ, ドパミン, ドブタミン, アムリノンを使用した. 心電図上, 頻拍性房室接合部調律となりベラパミルを併用し, 心拍数は軽度減少し心拍出量は維持されていた. 術後は洞調律, 房室接合部調律, 1度房室ブロックを認めていたが, 心房細動が再発した. 本症例では, 人工心肺離脱時の頻脈性不整脈と心機能低下の治療に難渋した. 頻脈性不整脈に対してベラパミルの投与が有効であった. 人工心肺離脱時の心機能低下に対しては高用量のカテコラミンは避け, アムリノンやIABPの使用を考慮すべきであると考えた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Maze procedure, Atrial fibrillation, Verapamil |
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| English |
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| Title | Anesthetic Manaqement of the Maze Procedure for Atrial Fibrillation |
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| Subtitle | |
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| Authors | Yoshie Fujii, Minoru Nomura, Izumi Kondo, Keiko Kodaka, Kimei Shirai, Hidehiro Suzuki |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology Tokyo Women's Medical Colleqe |
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| Journal | Circulation Control |
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| Volume | 16 |
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| Number | 3 |
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| Page | 391-395 |
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| Year/Month | 1995/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | The maze procedure is an operation performed to convert atrial fibrillation to sinus rhythm. A 44-year-old male with atrial fibrillation, mitral stenosis, mitral requrqitation, and aortic requrqitation, underwent the Maze procedure in addition to mitral and aortic valves replacement. General anesthesia was induced with fentanyl and diazepam, and maintained with fentanyl. We used dopamine, dobutamine and amrinone, each at a dose of 5 μg/kg/min, to prevent left ventricular dysfunction during weaning from cardiopulmonary bypass (CPB). He was also qiven verapamil for iunctional tachycardia. Cardiac output was preserved throuqhout the procedure. After CPB, sinus rhythm, iunctional rhythm and atrial-ventricular block were present. In this case, it was difficult to control heart rate and treat left ventricular dysfunction during weaning from CPB. We conclude that verapamil is effective in controlling tachycardia, and that the use of amrinone or intraaortic baloon pump can reduce doses of catecholamine to prevent severe arrhythmias. (Circ Cont 16：391〜395, 1995) |
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| Practice | Basic medicine |
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| Keywords | Maze procedure, Atrial fibrillation, Verapamil |
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