Torsade de pointes in liver transplantation recipient after induction of general anesthesia: A case report

Eun Jin Chung, Yun Seok Jeon, Hyun Joo Kim, Kook Hyun Lee, Ji Won Lee, Kyoung Ah Han, Seung Hwan Jung

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Torsade de pointes (TdP) is an uncommon and specific form of polymorphic ventricular tachycardia, associated with a prolonged QT interval. Prolongation of the QT interval is the most widely recognized electrophysiological abnormality in patients with liver cirrhosis. We observed a case of TdP leading to cardiopulmonary resuscitation after the induction of general anesthesia, in a patient with liver cirrhosis scheduled for emergency cadaveric donor liver transplantation. The patient had mild QT prolongation on preoperative electrocardiography with a corrected QT (QTc) interval of 455 ms. Drugs used in the preoperative period can elongate cardiac repolarization. Sevoflurane and 5-hydroxytryptamine type 3 receptor antagonists such as palonsetron, used during general anesthesia may have triggered further QT prolongation, producing a fatal condition such as TdP. More caution and consideration in selecting drugs for anesthetic management are necessary for liver cirrhosis patients, especially in patients with preoperative QT prolongation.

Original languageEnglish
Pages (from-to)80-84
Number of pages5
JournalKorean Journal of Anesthesiology
Volume66
Issue number1
DOIs
Publication statusPublished - Jan 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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