Canadian Journal of Anesthesia, Vol 19, 160-172, Copyright © 1972 by Canadian Anesthesiologists' Society

Anaesthesia for Ventricular Aneurysmectomy

¹ Department of Cardiothoracic Anesthesia, The Cleveland Clinic Foundation
² Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation

Our techinque of anaesthesia for resection of ventricular aneurysms is described. The haemodynamic changes which lead to decreased oxygen availability, increased oxygen consumption, and decreased cardiac output are kept in mind. Thiopentone, curare, and methoxyflurane are administered in does which provide adequate anaesthesia and avoid myocardial irritability or depression. Careful attention is given to maintaining coronary vasodilators. Blood gases, ph, and electrolytes, especially potassium, are monitored and maintained within normal limits, both during operation and postoperatively. Pharmacological support and return to partial cardiopulmonary bypass employed when the heart function is inadequate, are also discussed. The importance of monitoring left atrial pressure and correlating it with central venous pressure and mean blood pressure is emphasized. Evaluation of the amount of transfusion, status of transfusion, status of the myocardium, and the need for and the effectiveness of drug therapy are based on these observations. Postoperative arrhythmias are to be treated promptly and specifically. Prevention and management of postoperative respiratory complications are of the utmost importance.