[Suspected case of peripartum cardiomyopathy during perioperative period--a case report].

A 31-year-old primigravida was admitted for control of twin gestation and delivery. At 36-week gestation, an emergent cesarean section was performed under combined spinal-epidural anesthesia because of progression of PIH. Anesthetic course was uneventful until the operation was finished. An hour later, systolic blood pressure started to decline to reach about 70 mmHg and Sp(O2) about 80%. Pleural effusion was observed in the chest X-ray on post-operative day 1. Echocardiography showed akinesis of the antero-septal wall with ejection fraction (EF) of 47%. Peripartum cardiomyopathy (PPCM) was strongly suspected. HELLP syndrome and DIC were also combined with PPCM, so intensive care was given to her from the 1st POD. Symptoms of heart failure were alleviated by furosemide and carperitide by the 12th POD. The EF increased to 58% on the 11th POD.

[Anesthetic management of surgical intervention for contralateral pneumothorax after left pneumonectomy].

A 61-year-old man who had undergone left pneumonectomy 7 years before for lung cancer was scheduled for thoracoscopic partial pulmonary resection of the right lung because of pneumothorax. Anesthesia was induced with propofol and maintained with sevoflurane and thoracic epidural block. He was monitored with electrocardiogram, direct arterial pressure, pulse oximetry and capnogram. Arterial blood gas sampling was done as required. During the operation, ventilation was maintained with mechanical and intermittent manual ventilation. Hemodynamic status was stable and intra- and post-operative course was uneventful. PCPS, ECLS, CVC and PAC were not required. A successful and satisfactory anesthetic management was accomplished by good cooperation between anesthesiologists and surgeons.