{"title":"[动脉粥样硬化主动脉患者在心脏骤停状态下使用全身高钾血症进行二尖瓣置换术]。","authors":"Atsushi Yano, Kouhei Ishido, Toshio Katsube, Yoshiyuki Nagamine, Haruki Mikoshiba, Kohei Sumi, Yun Ryogen, Yousuke Mukae, Yoshinori Nakahara, Akira Marui, Tomohiro Iwakura","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>We report a successful case of mitral valve replacement and coronary artery bypass grafting under mild hypothermia and systemic hyperkalemia in a patient with severely atheromatous ascending aorta on which placing a clamp seemed contraindicated. A 78-year-old man was referred to our hospital with the diagnosis of heart failure associated with severe mitral regurgitation and coronary artery disease. Echocardiography showed severe mitral regurgitation due to A3, P3 and posterior commissure (PC) prolapse and coronary angiography showed three vessel disease. Computed tomography( CT) revealed a severely atheromatous ascending aorta. Surgery was performed under cardiac arrest using systemic hyperkalemia and superior transseptal approach. Although cardiopulmonary bypass (CPB) time was a little prolonged in order to wash out potassium with dilutional ultrafiltration, the patient was uneventfully separated from CPB. The patient had no neurological complications and was discharged from the hospital 15 days after surgery. Mitral valve replacement under cardiac arrest using systemic hyperkalemia without cross clamping the aorta is useful to avoid neurological complications.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Mitral Valve Replacement Under Cardiac Arrest Using Systemic Hyperkalemia in a Patient with Atheromatous Aorta].\",\"authors\":\"Atsushi Yano, Kouhei Ishido, Toshio Katsube, Yoshiyuki Nagamine, Haruki Mikoshiba, Kohei Sumi, Yun Ryogen, Yousuke Mukae, Yoshinori Nakahara, Akira Marui, Tomohiro Iwakura\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We report a successful case of mitral valve replacement and coronary artery bypass grafting under mild hypothermia and systemic hyperkalemia in a patient with severely atheromatous ascending aorta on which placing a clamp seemed contraindicated. A 78-year-old man was referred to our hospital with the diagnosis of heart failure associated with severe mitral regurgitation and coronary artery disease. Echocardiography showed severe mitral regurgitation due to A3, P3 and posterior commissure (PC) prolapse and coronary angiography showed three vessel disease. Computed tomography( CT) revealed a severely atheromatous ascending aorta. Surgery was performed under cardiac arrest using systemic hyperkalemia and superior transseptal approach. Although cardiopulmonary bypass (CPB) time was a little prolonged in order to wash out potassium with dilutional ultrafiltration, the patient was uneventfully separated from CPB. The patient had no neurological complications and was discharged from the hospital 15 days after surgery. Mitral valve replacement under cardiac arrest using systemic hyperkalemia without cross clamping the aorta is useful to avoid neurological complications.</p>\",\"PeriodicalId\":17841,\"journal\":{\"name\":\"Kyobu geka. The Japanese journal of thoracic surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Kyobu geka. The Japanese journal of thoracic surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kyobu geka. The Japanese journal of thoracic surgery","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
[Mitral Valve Replacement Under Cardiac Arrest Using Systemic Hyperkalemia in a Patient with Atheromatous Aorta].
We report a successful case of mitral valve replacement and coronary artery bypass grafting under mild hypothermia and systemic hyperkalemia in a patient with severely atheromatous ascending aorta on which placing a clamp seemed contraindicated. A 78-year-old man was referred to our hospital with the diagnosis of heart failure associated with severe mitral regurgitation and coronary artery disease. Echocardiography showed severe mitral regurgitation due to A3, P3 and posterior commissure (PC) prolapse and coronary angiography showed three vessel disease. Computed tomography( CT) revealed a severely atheromatous ascending aorta. Surgery was performed under cardiac arrest using systemic hyperkalemia and superior transseptal approach. Although cardiopulmonary bypass (CPB) time was a little prolonged in order to wash out potassium with dilutional ultrafiltration, the patient was uneventfully separated from CPB. The patient had no neurological complications and was discharged from the hospital 15 days after surgery. Mitral valve replacement under cardiac arrest using systemic hyperkalemia without cross clamping the aorta is useful to avoid neurological complications.