Eisenmenger症候群患者の全身麻酔下での抜歯経験

• Published in: 日本口腔外科学会雑誌 Vol. 63; no. 8; pp. 382 - 387
• Main Authors: 新谷, ゆかり, 東條, 格, 高山, 三郎, 岡本, 健二朗, 武田, 侑也, 藤田, 茂之
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.08.2017
• Subjects: アイゼンメンジャー症候群; 全身麻酔; 抜歯
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.63.382

Eisenmenger's syndrome is defined as the process through which an established left-to-right cardiac shunt caused by a congenital heart defect results in pulmonary hypertension and eventual reversal of the shunt into a cyanotic right-to-left shunt. The risk of mortality associated with non-cardiac surgery in patients with Eisenmenger's syndrome is considerable. We describe a patient with Eisenmenger's syndrome who required the extraction of several teeth under general anesthesia.　A 45-year-old woman was referred to our department because of a toothache and decreased dietary intake. Some teeth in the upper and lower jaws were decayed and required extraction. However, the patient had Down's syndrome as a complication, and she strongly refused to treat her teeth. We decided that it was too difficult for us to extract her teeth under local anesthesia. We planned to extract the teeth with the patient under general anesthesia by closely coordinating the procedure with her pediatrician and an anesthesiologist.　Consequently, the patient was treated without substantial changes in her cardiovascular dynamics or aggravation of hypoxemia, and the perioperative period was rendered suitable by close cooperation with her pediatrician and anesthesiologist.