远期心脏移植术后腹主动脉瘤支架注入术麻醉体会

远期心脏移植术后患者存在不同程度的心脏移植物血管病，冠状动脉造影表现为部分或弥漫性冠状动脉狭窄，是远期受者主要死亡原因之一。由于移植的心脏无植物神经支配，极少出现典型的心绞痛症状，至病变终末期才以严重的充血性心力衰竭或心律失常为首发症状。所以不论何种原因接受的心脏移植，移植后特别是长期生存者，应当按照冠心病处理原则进行诊治。本文总结了1例心脏移植患者术后8年发现腹主动脉瘤后行腹主动脉瘤支架注入术的过程，在术前及术中按照冠心病处理原则进行术前准备及围手术期管理，患者安全度过围术期，康复出院。...

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Bibliographic Details
Published in天津医药 Vol. 45; no. 6; pp. 632 - 633
Main Author 张志强;张山;孟利江
Format Journal Article
LanguageChinese
Published 石家庄市,河北医科大学第二医院麻醉科,050000 2017
Subjects
心脏移植;主动脉瘤,腹;组织支架;麻醉
组织支架
aortic aneurysm
心脏移植
heart transplantation
abdominal
主动脉瘤,腹
麻醉
tissue scaffolds
anesthesia
Online AccessGet full text
ISSN0253-9896
DOI10.11958/20170233

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Summary:远期心脏移植术后患者存在不同程度的心脏移植物血管病，冠状动脉造影表现为部分或弥漫性冠状动脉狭窄，是远期受者主要死亡原因之一。由于移植的心脏无植物神经支配，极少出现典型的心绞痛症状，至病变终末期才以严重的充血性心力衰竭或心律失常为首发症状。所以不论何种原因接受的心脏移植，移植后特别是长期生存者，应当按照冠心病处理原则进行诊治。本文总结了1例心脏移植患者术后8年发现腹主动脉瘤后行腹主动脉瘤支架注入术的过程，在术前及术中按照冠心病处理原则进行术前准备及围手术期管理，患者安全度过围术期，康复出院。
Bibliography:heart transplantation;aortic aneurysm,abdominal;tissue scaffolds;anesthesia
There are different degrees of cardiac allograft vasculopathy in patients with long term cardiactransplantation.Coronary angiography shows partial or diffuse coronary artery stenosis,which is one of the main causes ofdeath.There are few typical symptoms of angina pectoris because of no autonomic innervation in transplanted heart.The firstsymptom to the end of the disease is severe congestive heart failure or arrhythmia.So the principles of diagnosis andtreatment in long-term survivors should be in accordance with the coronary heart disease treatment.In this paper,wereported a case of anesthesia of a patient underwent stent implantation for abdominal aortic aneurysm after8years of cardiactransplantation.The preoperative preparation and perioperative management were performed according to the principle ofcoronary heart disease.The patient passed through the perioperative period safely.
12-1116/R
ISSN:0253-9896
DOI:10.11958/20170233