2021 年 12 巻 1 号 p. 51-55
Background: Because mitochondrial encephalomyopathy carries a risk of malignant hyperthermia, volatile inhalation anesthetics are contraindicated, but propofol can also carry the risk of propofol infusion syndrome. In recent years, increasing reports have shown that the use of volatile inhalation anesthetics can be safely managed for anesthesia. We report that sevoflurane made it possible to safely manage anesthesia in a patient with mitochondrial encephalomyopathy undergoing MitraClip® implantation.
Case presentation: The patient was a 82-year-old woman with mitral regurgitation (MR) and mitochondrial encephalomyopathy discovered by genetic testing. She also had rheumatoid arthritis and was taking steroids. Preoperative transthoracic echocardiography revealed severe MR due to left atrium dilatation. Due to her high risk for surgery, she was scheduled to undergo MitraClip® implantation. She was placed under general anesthesia, which was induced with midazolam, and neuromuscular monitoring was used for administration of a muscle relaxant. Anesthetic management was maintained with remifentanil and sevoflurane. After MitraClip® implantation, mitral regurgitation was reduced.
Conclusion: MitraClip® implantation in a patient with mitochondrial encephalomyopathy could be safely managed under monitoring using an inhalation anesthetic.
