Anesthetic Management for Left Colectomy in a Patient with a Left Atrial Thrombus Detected by Preoperative Transesophageal Echocardiogram

  • MIZOGAMI MAKI
    Department of Anesthesiology, Division of General Medicine Asahi University School of Dentistry
  • KURASHIGE SYUHEI
    Department of Anesthesiology, Division of General Medicine Asahi University School of Dentistry
  • UENO TAKAHIRO
    Department of Anesthesiology, Division of General Medicine Asahi University School of Dentistry
  • KONO TAKASHI
    Department of Anesthesiology, Division of General Medicine Asahi University School of Dentistry
  • FUJIWARA SHIGEKI
    Department of Anesthesiology, Division of General Medicine Asahi University School of Dentistry
  • TAKAKURA KO
    Department of Anesthesiology, Division of General Medicine Asahi University School of Dentistry

Bibliographic Information

Other Title
  • 術前の経食道心エコー図検査にて左房内血栓が判明した麻酔症例

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Description

A77-year-old man was scheduled for left colectomy under general anesthesia. A preoperative transesophagealechocardiogram(TEE )demonstrated a fixed, "mountain-type" thrombus within the left atrial appendage. Although itwas difficult to decide whether to perform, the colectomy or the anticoagulant therapy first, the left colectomy was firstperformed under general anesthesia, because of the strong wishes of the patient, apprehension about cancer progressionand the low embolic risk of "mountain-type" thrombus. During the operation, the thrombus was continuously observedwith TEE and neurosurgeons were available in case of emergency endovascular treatment. The perioperativehemodynamics were stable without acute ischemic stroke. The three-hour anesthetic management was completed successfully.After the operation, long-term anticoagulation therapy was needed. Therefore, operating on the cancer beforeanticoagulant therapy might have been the correct choice in this case.

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Details 詳細情報について

  • CRID
    1573950402319583488
  • NII Article ID
    110007473252
  • NII Book ID
    AN00053070
  • ISSN
    03850072
  • Text Lang
    ja
  • Data Source
    • CiNii Articles

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