Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography

Gilbert's syndrome (GS) is an autosomal inherited disorder characterized by relative deficiency of glucuronyl transferase and poor uptake of unconjugated bilirubin by hepatocytes. Cardiac surgery on cardiopulmonary bypass (CPB) in these patients triggers further hepatic dysfunction. Transesopha...

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Autores principales: Nagaraja, P. S., Singh, Naveen G., Subash, S., Manjunatha, N., Prabhushankar, C. G., Sathish, N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292861/
https://www.ncbi.nlm.nih.gov/pubmed/28217062
http://dx.doi.org/10.4103/1658-354X.197335
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author Nagaraja, P. S.
Singh, Naveen G.
Subash, S.
Manjunatha, N.
Prabhushankar, C. G.
Sathish, N.
author_facet Nagaraja, P. S.
Singh, Naveen G.
Subash, S.
Manjunatha, N.
Prabhushankar, C. G.
Sathish, N.
author_sort Nagaraja, P. S.
collection PubMed
description Gilbert's syndrome (GS) is an autosomal inherited disorder characterized by relative deficiency of glucuronyl transferase and poor uptake of unconjugated bilirubin by hepatocytes. Cardiac surgery on cardiopulmonary bypass (CPB) in these patients triggers further hepatic dysfunction. Transesophageal echocardiography (TEE) and Doppler assessment of hepatic vein help in assessing hepatic blood flow (HBF) during cardiac surgery. Here, we discuss anesthetic management and role of TEE in maintaining HBF perioperatively in a 25-year-old male patient with GS undergoing double valve replacement with tricuspid valve plasty. TEE-guided HBF monitoring and management of hepatic perfusion by modifying anesthetic and CPB protocol resulted in the favorable outcome.
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spelling pubmed-52928612017-02-17 Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography Nagaraja, P. S. Singh, Naveen G. Subash, S. Manjunatha, N. Prabhushankar, C. G. Sathish, N. Saudi J Anaesth Case Report Gilbert's syndrome (GS) is an autosomal inherited disorder characterized by relative deficiency of glucuronyl transferase and poor uptake of unconjugated bilirubin by hepatocytes. Cardiac surgery on cardiopulmonary bypass (CPB) in these patients triggers further hepatic dysfunction. Transesophageal echocardiography (TEE) and Doppler assessment of hepatic vein help in assessing hepatic blood flow (HBF) during cardiac surgery. Here, we discuss anesthetic management and role of TEE in maintaining HBF perioperatively in a 25-year-old male patient with GS undergoing double valve replacement with tricuspid valve plasty. TEE-guided HBF monitoring and management of hepatic perfusion by modifying anesthetic and CPB protocol resulted in the favorable outcome. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5292861/ /pubmed/28217062 http://dx.doi.org/10.4103/1658-354X.197335 Text en Copyright: © 2017 Saudi Journal of Anesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Nagaraja, P. S.
Singh, Naveen G.
Subash, S.
Manjunatha, N.
Prabhushankar, C. G.
Sathish, N.
Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography
title Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography
title_full Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography
title_fullStr Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography
title_full_unstemmed Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography
title_short Anesthetic management of a case of Gilbert's syndrome for mitral and aortic valve replacement: Role of transesophageal echocardiography
title_sort anesthetic management of a case of gilbert's syndrome for mitral and aortic valve replacement: role of transesophageal echocardiography
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292861/
https://www.ncbi.nlm.nih.gov/pubmed/28217062
http://dx.doi.org/10.4103/1658-354X.197335
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