Mitral valve replacement complicated by unsuspected pheochromocytoma

Advantages of Sutureless Aortic Valve in a Patient with Unsuspected Pheochromocytoma

“…Successful CABG both on and off-pump, 3 mitral valve replacement, 4 concurrent CABG with adrenalectomy, 5 and even heart transplant 6 have been described in patients with pheochromocytomas. We described a patient with an unanticipated pheochromocytoma undergoing combined AVR-CABG and postulate that the favorable outcome despite the hypertensive crisis was a result of (1) a high index of suspicion; (2) immediate aggressive treatment of the hypertension bearing in mind its pathophysiology, using phentolamine and labetalol; (3) expeditious surgery with short duration of aortic cross-clamping; and perhaps, (4) the quick implant time of a new sutureless prosthesis.…”

Emergency aortic valve replacement complicated by unsuspected pheochromocytoma

“…In a previous case with a pheochromocytoma suspected during the operation, an alpha-adrenergic blockade such as phentolamine and beta-adrenergic blockade such as propranolol were used in combination with nitroprusside for BP management. 5 Our patient suffered from an unpredicted hypertensive crisis that occurred after induction of anesthesia. Before we suspected a pheochromocytoma, nicardipine and nitroglycerin were used, then when the condition was revealed, those were promptly replaced by phentolamine, which was effective for lowering BP.…”

“…Patients with unrecognized pheochromocytoma who undergo anesthesia for unrelated surgery have significantly high risk for a hypertensive crisis. Five previous reports of cardiac surgeries completed despite complications encountered due to unsuspected pheochromocytoma are known, including coronary artery bypass grafting (CABG), 2 AVR, 3 concurrent AVR and CABG, 4 mitral valve replacement, 5 and even a heart transplant operation, 6 each an elective procedure. As noted in a study of cases of aortic dissection complicated by unsuspected pheochromocytoma, 7 reports of emergency cardiac surgery for patients with unsuspected pheochromocytoma are limited.…”

Emergency aortic valve replacement complicated by unmanaged pheochromocytoma

“…HR, heart rate; mBP, mean blood pressure; sBP, systolic blood pressure F I G U R E 2 (A) Left-side retroperitoneal mass noted at a previous hospital (yellow arrow). (B) Intense uptake of 123 Imetaiodobenzylguanidine by left adrenal shown by postoperative scintigraphy grafting (CABG), 2 AVR, 3 concurrent AVR and CABG, 4 mitral valve replacement, 5 and even a heart transplant operation, 6 each performed as an elective procedure. As noted in a study of cases of aortic dissection complicated by an unsuspected pheochromocytoma, 7 reports of emergency cardiac surgery for patients with that are limited.…”

“…Patients with an unrecognized pheochromocytoma who undergo anesthesia for an unrelated surgical procedure have a significantly high risk for a hypertensive crisis. Five previous reports of cardiac surgeries completed despite complications encountered due to an unsuspected pheochromocytoma are known, including coronary artery bypass grafting (CABG), 2 AVR, 3 concurrent AVR and CABG, 4 mitral valve replacement, 5 and even a heart transplant operation, 6 each performed as an elective procedure. As noted in a study of cases of aortic dissection complicated by an unsuspected pheochromocytoma, 7 reports of emergency cardiac surgery for patients with that are limited.…”