Anesthetic management of a patient with moyamoya disease undergoing mitral valve repair

Saki Ishikawa, Tatsuya Yamada, Ryota Sakaguchi, Eiki Hatorl, Hiroshi Morisaki

Research output: Contribution to journalArticle

Abstract

Moyamoya disease is the result of progressive steno-occlusive changes in the internal carotid arteries followed by formation of bilateral abnormal vascular networks. The disease may present with cerebral ischemia causing cerebral hemorrhage in the perioperative period. There are few reports of cardiac surgeries in patients with moyamoya disease, and the management during cardiopulmonary bypass for moyamoya disease has not been established We gave general anesthesia for mitral valve plasty in patient with the moyamoya disease. A 52-year-old woman underwent mitral valve plasty. She had been diagnosed with moyamoya disease and during the cardiopulmonary bypass, we used a-stat blood gas management with mild hypothermia and maintained Paco2 around 40 mmHg. We maintained the perfusion flow of CPB above 3.0 l • min-1 • m-2 and the mean perfusion pressure above 70 mmHg. In additioa we used the pulsatile perfusion assist with intraaortic balloon pumping to maintain cerebral circulation. Postoperative course was uneventful without apparent neurologic deficit, and she was discharged from hospital on 10th postoperative day.

Original languageEnglish
Pages (from-to)342-345
Number of pages4
JournalJapanese Journal of Anesthesiology
Volume63
Issue number3
Publication statusPublished - 2014

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Moyamoya Disease
Mitral Valve
Anesthetics
Cardiopulmonary Bypass
Cerebrovascular Circulation
Perfusion
Intra-Aortic Balloon Pumping
Pulsatile Flow
Perioperative Period
Cerebral Hemorrhage
Internal Carotid Artery
Disease Management
Neurologic Manifestations
Hypothermia
Brain Ischemia
General Anesthesia
Thoracic Surgery
Blood Vessels
Gases
Pressure

Keywords

  • Cardiopulmonary bypass
  • Moyamoya disease
  • α-stat blood gas management intraaortic balloon pumping

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Anesthetic management of a patient with moyamoya disease undergoing mitral valve repair. / Ishikawa, Saki; Yamada, Tatsuya; Sakaguchi, Ryota; Hatorl, Eiki; Morisaki, Hiroshi.

In: Japanese Journal of Anesthesiology, Vol. 63, No. 3, 2014, p. 342-345.

Research output: Contribution to journalArticle

Ishikawa, Saki ; Yamada, Tatsuya ; Sakaguchi, Ryota ; Hatorl, Eiki ; Morisaki, Hiroshi. / Anesthetic management of a patient with moyamoya disease undergoing mitral valve repair. In: Japanese Journal of Anesthesiology. 2014 ; Vol. 63, No. 3. pp. 342-345.
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