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Intraoperative myocardial infarction and refractory cardiogenic shock during major hepatectomy : a case report

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Title: Intraoperative myocardial infarction and refractory cardiogenic shock during major hepatectomy : a case report
Authors: Yagi, Yasunori Browse this author
Mizunoya, Kazuyuki Browse this author
Mori, Toshihiro Browse this author
Saito, Hitoshi Browse this author
Morimoto, Yuji Browse this author →KAKEN DB
Keywords: Myocardial infarction
Cardiogenic shock
Transesophageal Echocardiography
Issue Date: 9-Mar-2022
Publisher: Springer
Journal Title: JA Clinical Reports
Volume: 8
Issue: 1
Start Page: 19
Publisher DOI: 10.1186/s40981-022-00510-x
Abstract: Background Myocardial infarction (MI) complicated by cardiogenic shock during non-cardiac surgery is a rare but fatal complication. The management of intraoperative MI is challenging. Case presentation A 77-year-old hypertensive man with good functional capacity was scheduled for hepatectomy. After the start of liver resection, the electrocardiogram monitor showed ST depression, and the patient developed refractory cardiogenic shock. Transesophageal echocardiography revealed severe hypokinesis of the anteroseptal wall. The surgery was suspended, and an intra-aortic balloon pump was placed following immediate abdominal closure. Coronary angiography revealed severe stenosis of the left main coronary trunk, and percutaneous coronary intervention (PCI) was performed. Myocardial wall motion improved, and blood pressure stabilized. Two days after PCI, hepatectomy, which had been suspended, was successfully completed. Conclusions Once intraoperative MI has occurred, early diagnosis and multidisciplinary approaches are important to manage the difficult clinical situation.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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