2018, Number 4
<< Back Next >>
Rev Mex Anest 2018; 41 (4)
Aortic valve replacement in patients with rheumatoid arthritis: a challenge for difficult airway management
Rojas-Jaimes RA, Gaitán-Sastoque OA, Fernández-Hernández LY
Language: Spanish
References: 13
Page: 297-300
PDF size: 316.61 Kb.
ABSTRACT
Rheumatoid Arthritis is recognized as a major risk factor for heart valve disease. Symptomatic heart valve lesion more common in patients with rheumatoid arthritis is the aortic insufficiency. In patients with rheumatoid arthritis who have aortic insufficiency rarely it requires valve replacement. In a PubMed search with keywords rheumatoid arthritis and aortic valve replacement, only five cases published worldwide found. Board an anesthetic procedure on a patient with rheumatoid arthritis is a challenge, not only because of the high incidence of difficult intubation, but also due to the high cardiovascular risk. Here we report a case of aortic valve replacement for aortic regurgitation secondary to rheumatoid arthritis associated with a difficult airway resolved with a intubation with awake patient and prepositioning of laryngeal blockade at the Centro Médico Nacional 20 de Noviembre, ISSSTE.
REFERENCES
Shingaki M, Kobayashi Y, Suzuki H. A case of acute aortic insufficiency due to severe rheumatoid arthritis, showing progression in two weeks. Cardiovasc Diagn Ther. 2014;4:267-269.
Devlin AB, Goldstraw P, Caves PK. Aortic valve replacement in rheumatioid aortic incompetence. Thorax. 1978;33:612-615.
Müller M, Pippi-Ludwig W. Perioperatives management of patients with rheumatoid arthritis. Anaesthesist. 2014;11:883-894.
Hakala P, Randell T. Intubation difficulties in patients with rheumatoid arthritis. A retrospective analysis. Acta Anaesthesiol Scand. 1998;42:195-198.
Toumanidis ST, Papamichael CM, Antoniades LG, Pantelia MI, Saridakis NS, Mavrikakis ME, et al. Cardiac involvement in collagen diseases. Eur Heart J. 1995;16:257-262.
Isomäki H. Long-term outcome of rheumatoid arthritis. Scand J Rheumatol. 1992;95:3-8.
Coşkun S, Özoran K, Mermerci B, Aydoǧdu S, Keleş T. Cardiac involvement in patients with rheumatoid arthritis. APLAR J Rheumatol. 2005;8:23-31.
Corrao S, Sallì L, Arnone S, Scaglione R, Amato V, Cecala M, et al. Cardiac involvement in rheumatoid arthritis: evidence of silent heart disease. Eur Heart J. 1995;16:253-256.
Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, et al. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007;28:230-68.
Fombon FN, Thompson JP. Anaesthesia for the adult patient with rheumatoid arthritis. Contin Educ Anaesth Crit Care Pain. 2006;6:235-239.
Gu J, Xu K, Ning J, Yi B, Lu K. GlideScope-assisted fiberoptic bronchoscope intubation in a patient with severe rheumatoid arthritis. Acta Anaesthesiol Taiwan. 2014;52:85-87.
Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, Hagberg CA, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013;118:251e70.
Trivedi V, Sharma G. Evaluation of airway blocks versus general anesthesia for diagnostic direct laryngoscopy and biopsy for carcinoma of the larynx. J Indian Med Assoc. 2012;110:78-83