The Annals of Thoracic Surgery, Vol 53, 1114-1116, Copyright © 1992 by The Society of Thoracic Surgeons
Development of malignant hyperthermia during mitral valve replacement
RD Quinn, WE Pae Jr, SA McGary and GS Wickey
Division of Cardiothoracic Surgery, Pennsylvania State University College of Medicine, Hershey 17033.
Malignant hyperthermia is a genetically predisposed, potentially fatal
disorder triggered by anesthetic agents. The early diagnosis and treatment
of malignant hyperthermia is essential, yet often difficult, because the
signs and symptoms of this disorder are not unique to the disease. When the
patient is also undergoing cardiopulmonary bypass this disorder may be very
difficult to recognize. In this article, we report a case of malignant
hyperthermia diagnosed during mitral valve replacement and discuss the
preoperative and postoperative management possibilities. The unusualness of
this case stems from the fact that the patient had centronuclear myopathy.
Although reported with other types of myopathies, centronuclear myopathy
has rarely been associated with malignant hyperthermia. This episode of
malignant hyperthermia was diagnosed by intraoperative measurements showing
increased oxygen consumption despite hypothermic cardiopulmonary bypass.
