Successful experience with xenon anesthesia in a patient with dilated cardiomyopathy and intramedullary spinal cord tumor
2009
: The literature contains rare reports on anesthetic maintenance in non-cardiac operations in patients with dilated cardiomyopathy and an ejection fraction of less than 30%. Life-saving non-cardiosurgical interventions are performed in these patients since they are associated with a high risk for perioperative complications and fatal outcome. In these cases, anesthetic maintenance is performed with inotropic support; there is frequently a need to use a pacemaker, a cardioverter, or a LV assist device. The paper describes the first case of xenon anesthesia in a patient with dilated cardiomyopathy with an ejection fraction of less than 30% and rapidly progressing spinal cord tumor. The ability of xenon to maintain stable blood pressure and cardiac contractility could prevent perioperative infusion of inotropic agents. In 60-70% of cases, the maximum alveolar concentration of xenon enables anesthesia to be virtually performed as monoanesthesia without adding the anesthetics lowering cardiac contractility; the low blood-gas distribution coefficient ensures early emergence from anesthesia with early extubation and activation of a patient. In the author's opinion, xenon anesthesia has every reason to become the method of choice as anesthetic maintenance in patients with severe cardiac dysfunction.
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