A case of general anesthesia for a dental treatment before double heart-valve replacement

Introduction:Recently, the importance of the oral care has been recognized to eliminate the oral infection source in the perioperative period of cardiac surgery. Therefore, the general anesthesia for a dental treatment is sometime required before cardiac surgery. We report one case of the general anesthesia for an odontectomy and a cystectomy in a patient with serious heart valve disorder. Patient and Background: The patient is a 63-year-old man with advanced AS and moderate MS, for which double-valve replacement was planned. The guideline of the Japanese Circulation Society suggests that noncardiac surgery is usually recommended after valve replacement. However, the consultation among the related departments resulted that the oral surgery would precede from heart surgery in view of an infection source in this case. Anesthetic Management: The general anesthesia was induced with the propofol and was maintained by the air-oxygen- sevoflurane with fentanyl citrate. The cardiac performance was monitered by the Flo Trac Sensor throughout the operation, and passed satisfactorily. Conclusion: In a near future, it will be expected that a case like this increases in a highly efficient dental institution. Therefore, a closer and more integrated discussion with the sections related about the systemic management including general anesthesia is required. Keywords: General Anesthesia, Heart Disease, Infection Prevention, Double Valve Replacement