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Successful management of hypothermic cardiopulmonary bypass in a malignant hyperthermia susceptible patient


Department of Anesthesiology and Perioperative Medicine, Division of Cardiovascular Anesthesia, Augusta University, Augusta, GA, US

Correspondence Address:
Shvetank Agarwal
Department of Anesthesiology and Perioperative Medicine, Augusta University, Augusta, GA, 1120 15th Street, BIW-2144, Augusta, GA 30912
US
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_245_18

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Year : 2020  |  Volume : 23  |  Issue : 3  |  Page : 367-371

 

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Malignant hyperthermia (MH) is a potentially lethal reaction in those that are genetically predisposed, frequently triggered by inhaled anesthetics. MH is often difficult to diagnose because it is accompanied by signs and symptoms that are shared with other disorders. The diagnosis is further obscured in cardiac surgical patients, as the signs of MH can be masked by the cardiopulmonary bypass circuit (CPB) and the use of induced hypothermia. In this case-report, we describe the successful anesthetic management of a 65-year-old MH-susceptible female, confirmed via caffeine halothane contracture test, with aortic regurgitation and ascending aortic dilatation who underwent a Bentall procedure. We have also identified certain key measures for the safe anesthetic management of these patients.






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Department of Anesthesiology and Perioperative Medicine, Division of Cardiovascular Anesthesia, Augusta University, Augusta, GA, US

Correspondence Address:
Shvetank Agarwal
Department of Anesthesiology and Perioperative Medicine, Augusta University, Augusta, GA, 1120 15th Street, BIW-2144, Augusta, GA 30912
US
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_245_18

Rights and Permissions

Malignant hyperthermia (MH) is a potentially lethal reaction in those that are genetically predisposed, frequently triggered by inhaled anesthetics. MH is often difficult to diagnose because it is accompanied by signs and symptoms that are shared with other disorders. The diagnosis is further obscured in cardiac surgical patients, as the signs of MH can be masked by the cardiopulmonary bypass circuit (CPB) and the use of induced hypothermia. In this case-report, we describe the successful anesthetic management of a 65-year-old MH-susceptible female, confirmed via caffeine halothane contracture test, with aortic regurgitation and ascending aortic dilatation who underwent a Bentall procedure. We have also identified certain key measures for the safe anesthetic management of these patients.






[FULL TEXT] [PDF]*


        
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