PDF(Pubmed)
Abstract：
UNASSIGNED: Multiple sclerosis is known to be associated with both sympathetic and parasympathetic cardiovascular autonomic dysregulation. Thus, patients with multiple sclerosis comorbidity represent a potentially challenging patient population in cardiac surgery, especially in on-pump operations. Despite this, very little is known about the hemodynamics during cardiopulmonary bypass and the optimal perfusion strategy for patients with multiple sclerosis undergoing cardiac operations.
UNASSIGNED: In this report, the authors describe a patient with relapsing-remitting multiple sclerosis, who underwent successful triple valve operation for aortic and mitral stenosis and tricuspid valve insufficiency. Distinct blood pressure variations in form of temporary pressure dips were noted during total cardiopulmonary bypass time as well as during the reperfusion period.
UNASSIGNED: Pressure variations were not attributable to surgical, pharmacological or perfusion-related manoeuvres. Thus, they most likely represent symptoms of cardiovascular autonomic dysregulation manifesting during cardiopulmonary bypass. In this patient, blood pressure variations terminated spontaneously and remained within an acceptable range without external correction.
UNASSIGNED: When treating patients with multiple sclerosis comorbidity, the potential pressure variability due to cardiovascular autonomic dysregulation should be taken into consideration to avoid increased blood pressure volatility due to overcorrection or undercorrection during cardiopulmonary bypass.
UNASSIGNED: In this report, the authors describe a patient with relapsing-remitting multiple sclerosis, who underwent successful triple valve operation for aortic and mitral stenosis and tricuspid valve insufficiency. Distinct blood pressure variations in form of temporary pressure dips were noted during total cardiopulmonary bypass time as well as during the reperfusion period.
UNASSIGNED: Pressure variations were not attributable to surgical, pharmacological or perfusion-related manoeuvres. Thus, they most likely represent symptoms of cardiovascular autonomic dysregulation manifesting during cardiopulmonary bypass. In this patient, blood pressure variations terminated spontaneously and remained within an acceptable range without external correction.
UNASSIGNED: When treating patients with multiple sclerosis comorbidity, the potential pressure variability due to cardiovascular autonomic dysregulation should be taken into consideration to avoid increased blood pressure volatility due to overcorrection or undercorrection during cardiopulmonary bypass.
摘要：
■已知多发性硬化症与交感神经和副交感神经心血管自主神经失调有关。因此，患有多发性硬化症合并症的患者代表了心脏手术中潜在的挑战性患者群体，特别是在泵上操作。尽管如此,关于体外循环期间的血流动力学以及接受心脏手术的多发性硬化症患者的最佳灌注策略知之甚少.
■在本报告中，作者描述了一名复发缓解型多发性硬化症患者，因主动脉瓣和二尖瓣狭窄和三尖瓣关闭不全而成功接受了三瓣手术。在整个体外循环时间以及再灌注期间，注意到临时压力下降形式的明显血压变化。
■压力变化不归因于手术，药理学或灌注相关操作。因此，它们很可能代表体外循环期间出现的心血管自主神经失调的症状.在这个病人身上,血压变化自发终止,并保持在可接受范围内,无需外部校正.
■在治疗患有多发性硬化症合并症的患者时，应考虑心血管自主神经失调导致的潜在压力变异性,以避免体外循环期间过度校正或校正不足导致的血压波动增加.
■在本报告中，作者描述了一名复发缓解型多发性硬化症患者，因主动脉瓣和二尖瓣狭窄和三尖瓣关闭不全而成功接受了三瓣手术。在整个体外循环时间以及再灌注期间，注意到临时压力下降形式的明显血压变化。
■压力变化不归因于手术，药理学或灌注相关操作。因此，它们很可能代表体外循环期间出现的心血管自主神经失调的症状.在这个病人身上,血压变化自发终止,并保持在可接受范围内,无需外部校正.
■在治疗患有多发性硬化症合并症的患者时，应考虑心血管自主神经失调导致的潜在压力变异性,以避免体外循环期间过度校正或校正不足导致的血压波动增加.
