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Anesthetic management for combined mitral valve replacement and aortic valve repair in a patient with osteogenesis imperfecta


1 Department of Anesthesia, Jewish Hospital and St. Mary's Healthcare, Louisvile KY; Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisvile KY, USA
2 Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisvile KY, USA

Correspondence Address:
Jiapeng Huang
Department of Anesthesia, 200 Abraham Flexner Way, Louisville KY
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.81566

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Year : 2011  |  Volume : 14  |  Issue : 2  |  Page : 115-118

 

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Osteogenesis imperfecta is a rare disorder of connective tissues and presents multiple challenges, including difficult airway, hyperthermia, coagulopathy and respiratory dysfunction, for anesthesiologists, especially during cardiac surgery. We present anesthetic management of a patient with osteogenesis impertecta during double valve surgery. Dexmedetomidine infusion minimized the risks of malignant hyperthermia. Glidescope and in-line stabilization facilitated endotracheal intubation and protected his oral structures and cervical spine. Transesophageal echocardiography (TEE) diagnosed a flail A3 segment and redundant left coronary cusp causing mitral and aortic regurgitation. The mitral valve was replaced and the aortic valve repaired. Coagulopathy was corrected according to comprehensive coagulation analysis. Glidescope, dexmedetomidine, coagulation analysis and TEE could facilitate anesthetic management in these patients.






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1 Department of Anesthesia, Jewish Hospital and St. Mary's Healthcare, Louisvile KY; Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisvile KY, USA
2 Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisvile KY, USA

Correspondence Address:
Jiapeng Huang
Department of Anesthesia, 200 Abraham Flexner Way, Louisville KY
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.81566

Rights and Permissions

Osteogenesis imperfecta is a rare disorder of connective tissues and presents multiple challenges, including difficult airway, hyperthermia, coagulopathy and respiratory dysfunction, for anesthesiologists, especially during cardiac surgery. We present anesthetic management of a patient with osteogenesis impertecta during double valve surgery. Dexmedetomidine infusion minimized the risks of malignant hyperthermia. Glidescope and in-line stabilization facilitated endotracheal intubation and protected his oral structures and cervical spine. Transesophageal echocardiography (TEE) diagnosed a flail A3 segment and redundant left coronary cusp causing mitral and aortic regurgitation. The mitral valve was replaced and the aortic valve repaired. Coagulopathy was corrected according to comprehensive coagulation analysis. Glidescope, dexmedetomidine, coagulation analysis and TEE could facilitate anesthetic management in these patients.






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