ABSTRACT
BACKGROUND: Remimazolam is a short-acting benzodiazepine with small circulatory depression. We used remimazolam for general anesthesia management in two very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation (TAVI) plus off-pump coronary artery bypass grafting (OPCABG). CASE PRESENTATION: A 96-year-old man (case 1) and a 92-year-old woman (case 2) had complex coronary artery disease (CAD) and severe aortic stenosis (AS) and were scheduled for TAVI plus OPCAB. Anesthesia in both patients was induced with 6 mg/kg/h remimazolam and fentanyl and maintained with 0.3 mg/kg/h and 0.5 mg/kg/h remimazolam and fentanyl, respectively. Although catecholamines were required, we successfully maintained circulation during the induction of anesthesia and the procedures of OPCAB and TAVI. Both patients were discharged without complications. CONCLUSION: Remimazolam can be a useful option for safe general anesthesia in very elderly patients when performing hybrid surgery.
ABSTRACT
A series of P(3HB-co-3MP)s with different 3MP unit content was biosynthesized by the fermentation of W. eutropha in a medium containing sodium gluconate and DTDP as carbon sources at different pH conditions ranging from pH 6.0 to 8.0. The P(3HB-co-3MP) samples were fractioned using the solvent/nonsolvent mixed solvent chloroform/heptane and the comonomer unit composition was investigated. It was found that W. eutropha produces P(3HB-co-3MP)s with extremely different 3MP unit content ranging from 3.6 to 70.0 mol-%, depending on the pH value of the fermentation medium. The copolyester samples produced in mild basic medium have a considerably narrower compositional distribution than the samples from acidic medium. The highest polymer yield was obtained at pH 8.0.DSC diagram for P(3HB-co-3MP)s biosynthesized in different pH medium. [graph: see text] DSC diagram for P(3HB-co-3MP)s biosynthesized in different pH medium.
