Anesthetic management for patients with compromised left ventricular function due to coronary artery disease in non-cardiac surgery

摘要

BACKGROUND : As the number of patients suffering from coronary artery disease (CAD) increases, anesthetic management for these patients become more common than the past. But no established management strategies have been proven beneficial. METHODS : We reviewed all anesthetic management records of seven patients with compromised LV function (EF<30% or FS<30%) for CAD in our hospital, who had undergone non-cardiac operations. RESULTS : Three cases were brain surgeries and four cases were abdominal surgeries. In all cases, central venous catheters were placed before induction of general anesthesia. After inotropic agents were started through central venous catheters, patients went through induction with midazolam, fentanyl and propofol without any trouble. In three cases of abdominal surgeries, pulmonary artery catheters were placed. And in five cases, artery catheters were placed in the femoral arteries, so that, in case of cardiac shock, we could start IABP without delay. In one case, we experienced shock during operation, but without IABP, the patient recovered with pharmacological support. No patient died of cardiac cause during the hospital stay for the procedure. CONCLUSIONS : We reported anesthetic management of seven patients with compromised left ventricular function for CAD in non-cardiac surgery. However, as the reports of anesthetic management in patients with compromised left ventricular function in non-cardiac surgery is few, further study will be required.