ABSTRACT
BACKGROUND: We hypothesized that, even in patients taking aspirin, the variance of preoperative platelet response to collagen might be associated with myocardial injury during coronary artery bypass graft (CABG) surgery. Therefore, we evaluated the relationship between preoperative whole-blood aggregometry (WBA) by collagen and the postoperative myocardial injuries. METHODS: For 44 patients who were scheduled for elective off-pump CABG and taking aspirin, WBA was measured by the impedance method in the presence of collagen (2 mg/ml or 5 mg/ml) as stimulatory agents. After CABG, myocardial injury was evaluated by analysis of the creatine kinase (CK), creatine kinase-MB (CK-MB), and lactate dehydrogenase (LD), and by electrocardiography. RESULTS: High response group (n = 13) on preoperative WBA with collagen (2 and 5 mg/ml) showed significantly higher postoperative cardiac enzyme levels (CK, CK-MB and LD) than those of low response group (n = 31). CONCLUSIONS: In patients who take aspirin and undergoing off-pump CABG, the preoperative platelet response to collagen is correlated with postoperative myocardial injury.
Subject(s)
Humans , Aspirin , Blood Platelets , Collagen , Coronary Artery Bypass , Creatine , Creatine Kinase , Electric Impedance , Electrocardiography , L-Lactate Dehydrogenase , TransplantsABSTRACT
Neurofibromatosis type 2 (NF2) is a rare form of neurofibromatosis. Because the central nervous system involvement is predominant feature of NF2, the presence of intracranial and intraspinal neurofibroma make regional anesthesia difficult in patients with NF2.When diagnostic imaging study was not performed in NF2 parturient with CNS tumor involvement, general anesthesia is a better choice for delivery and not associated with the aggravation of neurofibromatosis.We report a case of parturient with NF2 whose emergency cesarean section was successfully managed with general anesthesia.Her neurological status was not worsened and her baby had no problem.