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[Anesthetic managements for pericardiectomy of three patients with constrictive pericarditis]
S Kurokawa1, S Fukuda, T Yamakura
1Department of Anesthesiology, Niigata University School of Medicine.
Insights
Percutaneous cardiopulmonary support (PCPS) reliably manages hemodynamics in constrictive pericarditis patients undergoing surgery. This technique is crucial for stabilizing patients with severe tachycardia or during complex pericardiectomy procedures.
Area of Science:
- Cardiology
- Cardiac Surgery
- Anesthesiology
Background:
- Constrictive pericarditis presents significant anesthetic challenges.
- Surgical intervention, such as pericardiectomy, is often necessary.
- Hemodynamic instability is a major concern during surgery for these patients.
Observation:
- Three patients with constrictive pericarditis underwent pericardiectomy.
- Two patients required percutaneous cardiopulmonary support (PCPS) due to intraoperative hemodynamic compromise from bleeding or cardiac compression.
- One patient with severe tachycardia had PCPS prepared pre-anesthesia, enabling successful management.
Findings:
- Percutaneous cardiopulmonary support (PCPS) effectively stabilized hemodynamics in patients with constrictive pericarditis during surgery.
- PCPS provided crucial circulatory support, mitigating risks associated with massive bleeding, cardiac compression, and severe tachycardia.
- The use of PCPS facilitated satisfactory anesthetic management throughout the procedures.
Implications:
- PCPS is a highly reliable method for hemodynamic support in patients with constrictive pericarditis undergoing anesthesia and surgery.
- This approach can improve surgical outcomes and patient safety in complex cardiac cases.
- Consideration of prophylactic PCPS may be beneficial for high-risk patients, such as those with severe tachycardia.
Abstract:
We experienced three patients with constrictive pericarditis who underwent pericardiectomy. Percutaneous cardiopulmonary support (PCPS) was carried out in two patients because of unstable hemodynamics caused by massive bleeding or cardiac compression due to surgical manipulation. In the other patient with severe tachycardia, we prepared PCPS before the induction of anesthesia, and could manage the whole course of anesthesia satisfactorily. It is suggested that PCPS is the most reliable way to support hemodynamics during anesthesia in patients with constrictive pericarditis.