Anesthetic Management of 10 Heart Transplantation cases / 대한마취과학회지

ABSTRACT

BACKGROUND: For 3 years since November, 1992, when first heart transplantation was performed in Asan Medical Center, total of 16 heart failure patients underwent that operation with succesful results. We are describing anesthetic management of former 10 cases. METHODS: Retrospective study by reviewing patients' medical records. RESULTS: Recipients had severe heart failure and pulmonary hypertension. Their age distribution was between 22 and 50 years and ratio of male to female was 82. Careful administration of midazolam and fentanyl was the preferred induction method and vecuronium was used for both intubation and maintenance in most of the cases. High dose narcotic technique(fentanyl 100 microgram/kg) was satisfactory for the induction and maintenance of anesthesia. Sterile technique was used placing endotracheal tubes and catheterizations. After transplantation, dobutamine, dopamine, isoproterenol and isosorbide dinitrate(Isoket) were required to support venticular performances. At ICU, postoperative courses were uneventful. Average duration of ICU stay was 10 days. There was no mortality. CONCLUSIONS: Anesthetic management of heart transplantation patients regarding fentanyl anesthesia, sterile technique,inotropic drug usages were described.