骨髄異形成症候群と肥大型心筋症を合併した症例の麻酔管理

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  • Anesthetic Management in a Patient with Myelodysplastic Syndrome and Hypertrophic Cardiomyopathy.

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A 78-year-old man had been diagnosed as myelodysplastic syndrome two years ago. Preoperative evaluation for removal of maxillary tumor revealed severe pancytopenia and trifascicular block on the ECG. The echocardiogram showed hypertrophic cardiomyopathy. He received two units of packed red blood cell and 15 units of concentrated platelets on the day before the operation. General anesthesia was maintained with sevoflurane and 50% nitrous oxide in oxygen under the monitoring of pulmonary artery catheter. The perioperative course was uneventful without any serious bradyarrhythmias. We conclude that it is important to keep optimal oxygen transport and hemostatic function by administration of blood products, and to prevent the myocardial ischemia by vigilant hemodynamic monitoring.

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