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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2001 March;67(3):149-53

language: English

Abdominal aortic aneurysm resection following cholecystectomy and heart transplantation. Case report

Cristalli A., De Gasperi A., Prosperi M., Mazza E., Puttini M. *, Palmieri B. *

From the Ospedale Niguarda Ca’ Granda - Milano II - III Servizio di Anestesia e Rianimazione (Primario: Dott. M. Merli)
*Sezione Autonoma di Chirurgia Vascolare


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The ­case of a ­patient who under­went ­heart trans­plan­ta­tion and chol­e­cys­tec­to­my in 1993 and admit­ted for resec­tion of abdom­i­nal aor­tic aneu­rysm in May 1997, is report­ed. About 25 min­utes ­after unclamp­ing the abdom­i­nal aor­ta the ­patient’s ­blood pres­sure ­fell sud­den­ly to 70/40 mmHg. In ­spite of vig­or­ous ­fluid admin­is­tra­tion and infu­sion of Dopamine and Adrenaline the hemo­dy­nam­ic pat­tern ­returned to nor­mal ­only 15 min­utes lat­er. The authors dis­cuss the pos­sible expla­na­tions of ­this beha­vi­our (mes­en­ter­ic trac­tion syn­drome, hypo­vo­le­mia) and con­clude ­that ­heart trans­plant ­patients are par­tic­u­lar­ly affect­ed by hypo­ten­sion. Of par­a­mount impor­tance ­remains there­fore the cor­rect eval­u­a­tion of ade­quate fill­ing pres­sures ­which ­should be main­tained slight­ly ­above nor­mal ­range.

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