Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/13494
Title: Orthotopic liver transplantation in two patients with hypertrophic obstructive cardiomyopathy.
Authors: Harley, I D;Jones, Elizabeth F;Liu, G;McCall, Peter R;McNicol, P L
Affiliation: Department of Anaesthesia and Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia.
Issue Date: 1-Nov-1996
Citation: British Journal of Anaesthesia; 77(5): 675-7
Abstract: Orthotopic liver transplantation (OLT) in patients with end-stage liver disease is a procedure associated with high cardiac output, low systemic vascular resistance (SVR), coagulopathy and the potential for significant blood loss. A feature of hypertrophic obstructive cardiomyopathy (HOCM) is left ventricular outflow tract obstruction which may be exacerbated by reduced SVR, reduced filling pressures, tachycardia and positive inotropy. We report two cases of OLT in patients with HOCM. Our anaesthetic technique involved the use of halothane and vecuronium and avoidance of drugs causing tachycardia and positive inotropy. Management was aided by intraoperative transoesophageal echocardiography which showed that filling pressures poorly reflected end-diastolic volumes. Volume administration, vasoconstrictors and avoidance of inotropes and chronotropes reduced the outflow tract obstruction which was particularly severe in the reperfusion period.
Internal ID Number: 8957992
URI: http://ahro.austin.org.au/austinjspui/handle/1/13494
URL: http://www.ncbi.nlm.nih.gov/pubmed/8957992
Type: Journal Article
Subjects: Anesthesia, General.methods
Cardiomyopathy, Hypertrophic.complications.physiopathology.ultrasonography
Echocardiography, Transesophageal
Hemodynamics
Humans
Liver Transplantation.methods
Male
Middle Aged
Monitoring, Intraoperative.methods
Appears in Collections:Journal articles

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