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Updated: Apr 8, 2026
A Modified Murine Heterotopic Heart Transplant Protocol Matching Contemporary Standards of Aseptic Technique, Anesthesia, and Analgesia
Published on: September 28, 2022
[Anesthetic Management for Endoscopic Sinus Surgery in a Patient with Transplanted Heart--A Case Report]
Insights
This study details anesthetic management for a heart transplant recipient with X-linked dilated cardiomyopathy undergoing endoscopic sinus surgery. Careful anesthetic choices ensured a smooth recovery without complications, highlighting safe practices for complex cardiac patients.
Area of Science:
- Cardiology
- Anesthesiology
- Genetics
Background:
- A 19-year-old male with a transplanted heart, diagnosed with X-linked dilated cardiomyopathy, underwent endoscopic sinus surgery one year post-transplant.
- Preanesthetic evaluation revealed elevated lactate dehydrogenase, suggesting striated muscle involvement, but normal heart function.
Observation:
- Total intravenous anesthesia was administered using propofol and remifentanil, with rocuronium solely for intubation.
- Neuromuscular blockade reversal was not required, and the patient awoke smoothly with a train-of-four ratio of 95%.
Findings:
- No inotropic agents or reversal medications (atropine, neostigmine, sugammadex) were administered post-operatively.
- The patient was discharged five days after surgery without any complications.
Implications:
- This case demonstrates successful anesthetic management in a complex patient with a denervated heart and myopathy.
- It underscores the importance of tailored anesthetic strategies for heart transplant recipients with underlying genetic cardiomyopathies.
Abstract:
A 19-year-old male patient with transplanted heart received endoscopic sinus surgery. He was with X-linked dilated cardiomyopathy, and was one year after the transplantation. Preanesthetic study showed lactate dehydrogenase elevation estimated to have derived from striated muscle. Heart function was normal, and other abnormal findings were not revealed. Total intravenous anesthesia was performed with propofol target controlled infusion and remifentanil. Rocuronium was administered only for oro-tracheal ntubation. After the operation, train-of-four ratio was 95%, and he awoke from anesthesia smoothly. We did not use atropine, neostigmine or sugammadex to reverse neuromuscular blockade. No inotropic agent was administered. He was discharged from the hospital 5 days after the operation without any complications. We used usual anesthetic management but we had to be careful about both denervated heart and myopathy.
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