Coronary Artery Bypass Grafting in a Patient with Myasthenia Gravis

2014 ◽  
Vol 17 (5) ◽  
pp. 239 ◽  
Author(s):  
Tolga Demir ◽  
Murat Ugurlucan ◽  
Fatma Bahceci ◽  
Hale Bolgi Demir ◽  
Selma Sezer
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Myasthenia Gravis ◽  
Coronary Artery Bypass ◽  
Anesthetic Management ◽  
Artery Bypass ◽  
Rare Condition ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Triple Vessel Disease

A 70-year-old male patient with myasthenia gravis required coronary artery bypass grafting due to triple-vessel disease. The anesthetic management was performed with general anesthesia using reduced doses of muscle relaxants. He was extubated four hours after surgery and the postoperative course was uneventful. Coronary artery bypass surgery in myasthenic patients can be challenging to anesthesiologists and cardiac surgeons. In this rare condition, a meticulous assessment of the patient's neurologic and cardiac status, and careful perioperative anesthetic management were needed in order to avoid life-threatening complications in both intraoperative and postoperative periods.

scholarly journals Anesthetic management of a patient with situs inversus totalis undergoing coronary artery bypass grafting surgery: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chigusa Nakasone ◽  
Masafumi Kanamoto ◽  
Wataru Tatsuishi ◽  
Tomonobu Abe ◽  
Shigeru Saito
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Situs Inversus ◽  
Anesthetic Management ◽  
Artery Bypass ◽  
Situs Inversus Totalis ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Intraoperative Management

Abstract Background Anesthetic management of coronary artery bypass grafting surgery (CABG) in a dextrocardia patient with situs inversus totalis is rarely encountered and seldom reported in the literature. Case presentation A 76-year-old Japanese female patient had been diagnosed with situs inversus totalis and coronary artery disease of 3 vessels, and she subsequently underwent elective CABG. A preoperative examination showed almost normal results. ECG showed right deviation with the normal lead position. In the operating room, ECG leads were applied in reverse. Pulmonary artery catheterization was performed via the left internal jugular vein. A transesophageal echocardiography (TEE) probe was introduced without difficulty. A different angle was needed to acquire the desired views because of her atypical anatomy. Conclusion Careful perioperative evaluation, intraoperative management, and inspection of multiplane angle and probe adjustments in TEE are needed for anatomically abnormal patients.

scholarly journals Coronary Artery Bypass Grafting in a Patient with Dextrocardia with Situs Inversus

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Kaitlin E. Woods ◽  
J. W. Awori Hayanga ◽  
Daniel Sloyer ◽  
Roy E. Henrickson ◽  
Lawrence M. Wei ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Situs Inversus ◽  
Anesthetic Management ◽  
Artery Bypass ◽  
Direct Access ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
The Right

Dextrocardia involves embryologic malformations leading to a right hemithorax heart with rightward apex. Situs inversus encompasses all viscera in mirrored position. A 76-year-old male with dextrocardia with situs inversus presented for coronary artery bypass grafting due to a non-ST elevation myocardial infarction. Management was altered accordingly. Electrocardiography leads and defibrillator pads were reversed. A left internal jugular vein central venous catheter provided direct access to the right atrium. Transesophageal echocardiography confirmation of aortic and venous cannulation required turning the probe right for the right-sided aorta and left for liver visualization, respectively. Proactive surgical and anesthetic management was imperative for the successful and uneventful outcome for this patient.

scholarly journals Influence of multimodal low-opioid anesthesia on the dynamics of аnnexin V in blood plasma during cardiac surgery

2020 ◽  
pp. 20-28
Author(s):  
S.R. Maruniak ◽  
◽  
O.A. Loskutov ◽  
O.M. Druzhyna ◽  
I.R. Malish ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Interleukin 6 ◽  
Anesthetic Management ◽  
Artery Bypass ◽  
Control Group ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Standard Scheme

The aim – to analyze the effect of anesthesia on the dynamics of аnnexin V during coronary artery bypass grafting with сardiopulmonary bypass (CPB), and the dependence of direct clinical results on the expression of аnnexin V. Materials and methods. The study included 30 patients with coronary heart disease who underwent coronary artery bypass grafting with application of 2–3 aortocoronary anastomoses with CPB. According to the anesthetic management, all patients were divided into two groups: the first group (13 patients) – low opioid anesthetic scheme; control group (17 patients) – a standard scheme of anesthetic management. The determination of the level of аnnexin V in the blood was carried out before CPB and after bringing the sternum by enzyme-linked immunosorbent assay. Results. The low-opioid scheme of anesthetic management was associated with significantly (by 1.5 times) lower level of аnnexin V and by 28.38 % lower level of interleukin-6 at the end of the surgery as compared to the standard scheme. A significant negative correlation (r = –0.117, p = 0.523) was found between the levels of аnnexin V and interleukin-6. One-way analysis of variance showed that patients who had low cardiac output syndrome in the postoperative period had a significantly higher level of аnnexin V after CPB (p = 0.001). Conclusions. The use of multimodal low-opioid anesthesia is characterized by relative safety, a sufficient level of analgesia and lower level of аnnexin V compared to the control group. Key words: coronary artery bypass grafting, low-opioid anesthesia, apoptosis, аnnexin V, interleukin-6.

scholarly journals Coronary Artery Bypass Grafting in a Patient With Situs Inversus Totalis: A Case Report

2021 ◽  
Author(s):  
Atsushi Oi ◽  
Wataru Tatsuishi ◽  
Jun Mohara ◽  
Toshikuni Yamamoto ◽  
Tomonobu Abe
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Situs Inversus ◽  
Artery Bypass ◽  
Situs Inversus Totalis ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Triple Vessel Disease ◽  
The Right

Abstract Background: Coronary artery bypass grafting in situs inversus totalis patients has been seldom reported in the literature. Case presentation: A 76-year-old woman visited our hospital for chest pain and dyspnea that had started about 5 years earlier. Coronary angiography revealed triple-vessel disease, and computed tomography showed situs inversus totalis. Coronary artery bypass grafting was performed. In this case, the main operating surgeon stood on the right side of the patient until cardiopulmonary bypass was established and then switched positions to the left side of the patient for anastomosis.Conclusion: CABG was successfully completed in a patient with situs inversus totalis. The position shift helped improve the safety and ease of the surgery.

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