Soonchunhyang Med Sci.  2018 Jun;24(1):95-98. 10.0000/sms.2018.24.1.95.

Anesthetic Management for Elective Total Hip Replacement Arthoroplasty in a Patient with Eisenmenger's Syndrome

• Chung J
• Park J
• Seo Y
• Gong H

• KMID: 2437776
• DOI: http://doi.org/10.0000/sms.2018.24.1.95

Abstract

Eisenmenger's syndrome describes the elevation of pulmonary arterial pressure to the systemic level caused by an increased pulmonary vascular resistance with reversed or bi-directional shunt through an intracardiac or aortopulmonary communication. We report the case of 48-year-old woman with an elective total hip replacement arthroplasty for right femur neck fracture with Eisenmenger's syndrome secondary to large atrial septal defect. Anesthesia was induced with etomidate and rocuronium, maintained with desflurane 5 vol% and Oâ‚‚ 3 L/min. Mirinone and norepinephrine were infused continuously to decrease right to left shunt. The patient was extubated after spontaneous breathing recovery and transferred to the intensive care unit. She was treated with mirinone, norepinephrine, dopamine, and dobutamine for hypoxemia and hypotension. After 3 hours of admission to intensive care unit, the patient had a cardiac arrest and died 30 minutes later.

Keyword

Anesthesia; Eisenmenger complex; Pulmonary hypertension

MeSH Terms

Anesthesia
Anoxia
Arterial Pressure
Arthroplasty
Arthroplasty, Replacement, Hip*
Dobutamine
Dopamine
Eisenmenger Complex*
Etomidate
Female
Femoral Neck Fractures
Heart Arrest
Heart Septal Defects, Atrial
Humans
Hypertension, Pulmonary
Hypotension
Intensive Care Units
Middle Aged
Norepinephrine
Respiration
Vascular Resistance
Dobutamine
Dopamine
Etomidate
Norepinephrine