| Malignant Hyperthermia after
Surgical Repair of Acute Type A Aortic Dissection |
(Department of Cardiovascular Surgery, Himeji Cardiovascular
Center, Himeji, Japan)
| Tomoki Hanada |
Nobuhiko Mukohara |
Naoto Morimoto |
| Hironori Matsuhisa |
Ayako Maruo |
Hiroya Minami |
| Keitaro Nakagiri |
Masato Yoshida |
Hidefumi Obo |
| Tsutomu Shida |
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|
A 45-year-old man underwent total
arch replacement for acute type A aortic dissection. Vital signs
during the operation remained stable, but sinus tachycardia was
recognized about 7h postoperatively, followed by a high level
of PaCO2 , low
level of PaO2
and metabolic acidosis. Then, blood pressure decreased, accompanied
rapid elevation of body temperature to 39.7℃. Body temperature
was decreased gradually by cooling the whole body, however, coma,
anuria and hypoxemia persisted. A diagnosis of malignant hyperthermia
was made and Dantrolene was administered. However, the patient
died of multiple organ failure 7 days postoperatively. The serum
level of CPK increased to 12,446 IU/l and serum myoglobin
elevated to a very high level (36,500ng/ml) 2 days postoperatively.
Although, it is very rare for malignant hyperthermia to develop
after open-heart surgery, physicians must keep this disease in
mind if sudden hyperthermia of unknown origin is demonstrated.
Jpn. J. Cardiovasc. Surg. 34: 198-201 (2005) |
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