Malignant Hyperthermia after Surgical Repair of Acute Type A Aortic Dissection

VernacularTitle:急性Ａ型大動脈解離術後に発症した悪性高熱の１例
Author: Tomoki Hanada ; Nobuhiko Mukohara ; Naoto Morimoto ; Hironori Matsuhisa ; Ayako Maruo ; Hiroya Minami ; Keitaro Nakagiri ; Masato Yoshida ; Hidefumi Obo ; Tsutomu Shida
Publication Type:Journal Article
From:Japanese Journal of Cardiovascular Surgery 2005;34(3):198-201
CountryJapan
Language:Japanese
Abstract: A 45-year-old man underwent total arch replacement for acute type A aortic dissection. Vital signs during the operation remained stable, but sinus tachycardia was recognized about 7h postoperatively, followed by a high level of PaCO₂, low level of PaO₂ and metabolic acidosis. Then, blood pressure decreased, accompanied rapid elevation of body temperature to 39.7°C. Body temperature was decreased gradually by cooling the whole body, however, coma, anuria and hypoxemia persisted. A diagnosis of malignant hyperthermia was made and Dantrolene was administered. However, the patient died of multiple organ failure 7 days postoperatively. The serum level of CPK increased to 12, 446IU/l and serum myoglobin elevated to a very high level (36, 500ng/ml) 2 days postoperatively. Although, it is very rare for malignant hyperthermia to develop after open-heart surgery, physicians must keep this disease in mind if sudden hyperthermia of unknown origin is demonstrated.