Anesthetic Management of a Heart Transplant Recipient Undergoing Ascending Aortoplasty with a Homograft Patch

Abstract

  A 16 year-old male heart transplant recipient underwent aortoplasty with a homograft patch for pseudoaneurysm of the ascending aorta with extracorporeal circulation (ECC). The patient had undergone cardiac transplantation 5 months before for dilated cardiomyopathy. During this procedure, a piece of an arterial cannula was accidentally left in. Subsequently, this piece developed a pseudoaneurysm due to infection. He had not developed significant transplant complications. His physical status was satisfactory and the preoperative laboratory data were within normal limits apart from anemia (Hb 7.2 g/dl). General anesthesia was induced and maintained with propofol, remifentanil and rocuronium.
  The circulatory system was maintained satisfactorily during the peri-operative period by ensuring sufficient fluid preloading in order to maintain adequate cardiac output from the denervated heart.