[Intraoperative management and prognosis of patients for emergency cardiovascular surgery]

We analyzed patient characteristics, the management of anesthesia, and prognosis, etc. in 13 patients for emergency valvular heart surgery (V) and 28 patients for emergency aortic surgery (A). The patients in group A were significantly older than those in the group V. Fentanyl was used as the main anesthetic agent in all patients in the group V and in most of the patients in the group A. Five patients undergoing abdominal aortic surgery in the group A received epidural anesthesia concomitantly with general anesthesia. Postoperatively more than half of the group V patients required some kind of mechanical support, such as IABP, to maintain hemodynamic stability, as well as catecholamine infusion which all of the group V patients received. Six of the 13 patients in the group V died postoperatively. They had received prosthetic aortic valve replacement. Three of them died from LOS and the other 3 from MOF. Seven of the 28 patients in the group A died perioperatively. They all had had descending thoracic aortic aneurysm. Gastrointestinal tract bleeding and/or necrosis were seen in 4 of the 6 patients who died postoperatively. We found that the prognosis of emergency cardiovascular surgery is quite poor, and anesthesiologist should take sufficient care in the management of these patients throughout the perioperative period.