Journal article
Efficacy of amiodarone on refractory ventricular fibrillation resistant to lidocaine and cardioversion during weaning from cardiopulmonary bypass in aortic valve replacement for severe aortic stenosis with left ventricular hypertrophy
Journal of anesthesia, Vol.24(5), pp.761-764
10/01/2010
DOI: 10.1007/s00540-010-0991-5
PMID: 20665054
Abstract
Intravenous injection of amiodarone, a class III anti-arrhythmic is widely used for persistent refractory arrhythmias. We present a case report suggesting the efficacy of amiodarone in refractory ventricular fibrillation (Vf) during weaning from cardiopulmonary bypass (CPB). A 66-year-old woman with hypertension had a medical examination as a result of an episode of palpitations and syncope. Echocardiography and an invasive hemodynamic study revealed severe aortic stenosis (AS) with left ventricular (LV) hypertrophy because of calcified degeneration in a congenital bicuspid aortic valve (AV). Aortic valve replacement (AVR) was scheduled under general anesthesia and CPB. Intraoperative diagnosis was AS with calcified AV, LV hypertrophy, and aneurysm of ascending aorta (Ao). AVR with a biological valve, artificial vessel replacement of ascending Ao, and excision of the outflow myocardial septum were performed under CPB with intermittent antegrade blood cardioplegia at a body temperature (BT) of 24A degrees C. The patient suffered from Vf at a BT of 35.3A degrees C. Vf was not responsive to lidocaine 100 mg and 10 direct current (DC) shocks. After continuous intravenous infusion of amiodarone 225 mg/h for 10 min and a single intravenous injection of amiodarone 150 mg followed by a single DC shock, she returned to normal sinus rhythm. Sinus rhythm was maintained by continuous intravenous infusion of amiodarone 60 mg/h. Total CPB time was 5 h 43 min. Aortic cross-clamping time was 3 h 50 min. Administration of amiodarone is effective for refractory Vf resistant to lidocaine and cardioversion during weaning from CPB in cardiac surgery for heart diseases with LV hypertrophy.
Details
- Title: Subtitle
- Efficacy of amiodarone on refractory ventricular fibrillation resistant to lidocaine and cardioversion during weaning from cardiopulmonary bypass in aortic valve replacement for severe aortic stenosis with left ventricular hypertrophy
- Creators
- Yoshihisa Morita - Teikyo UniversityJu Mizuno - Teikyo UniversityTatsuya Yoshimura - Teikyo UniversityShigeho Morita - Teikyo University
- Resource Type
- Journal article
- Publication Details
- Journal of anesthesia, Vol.24(5), pp.761-764
- Publisher
- Springer Nature
- DOI
- 10.1007/s00540-010-0991-5
- PMID
- 20665054
- ISSN
- 0913-8668
- eISSN
- 1438-8359
- Number of pages
- 4
- Language
- English
- Date published
- 10/01/2010
- Academic Unit
- Anesthesia
- Record Identifier
- 9984656529102771
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