Malignant Hyperthermia after Surgical Repair of Acute Type A Aortic Dissection

(Department of Cardiovascular Surgery, Himeji Cardiovascular Center, Himeji, Japan)

Tomoki Hanada Nobuhiko Mukohara Naoto Morimoto
Hironori Matsuhisa Ayako Maruo Hiroya Minami
Keitaro Nakagiri Masato Yoshida Hidefumi Obo
Tsutomu Shida
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. 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 12,446 IU/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.
@Jpn. J. Cardiovasc. Surg. 34: 198-201 (2005)