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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

Copyright © 2009 EDIZIONI MINERVA MEDICA

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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