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The Japanese Journal of Thoracic Surgery Volume 72, Issue 5 （May 2019）

胸部外科 72巻5号（2019年5月発行）

Japanese English

症例

減量後に心臓手術を施行した高度肥満の2例 Extreme Obese Patients who Underwent Cardiac Surgery after Preoperative Weight Reduction；Report of Two Cases 内藤潤 ¹ , 松永裕樹 ¹ , 三島秀樹 ¹ , 小林亜紀 ¹ , 高橋正道 ¹ , 松岡勇二郎 ¹ , 尾辻瑞人 ¹ , 石川進 ¹ Jun Naito ¹ , Hiroki Matsunaga ¹ , Hideki Mishima ¹ , Aki Kobayashi ¹ , Masamichi Takahashi ¹ , Yujiro Matsuoka ¹ , Mizuto Otsuji ¹ , Susumu Ishikawa ¹ ¹東京都立墨東病院 ¹Department of Cardiovascular Surgery, Tokyo Metropolitan Bokutoh Hospital キーワード：心臓手術 , 肥満 , 減量 , 非侵襲的陽圧換気（NPPV） Keyword: cardiac surgery , obesity , weight reduction , non-invasive positive pressure ventilation （NPPV） pp.389-394

発行日 2019年5月1日 Published Date 2019/5/1

DOI https://doi.org/10.15106/j_kyobu72_389

PDF(388KB)

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参考文献 Reference

はじめに　一般的に肥満は，術中・術後のさまざまな合併症のリスク因子であるといわれている．高度肥満例における心臓手術では，手術時期や周術期管理の面でいまだ議論の余地がある．われわれは，body mass index（BMI）40を超える高度肥満の2例で，減量後に心臓手術を行い良好な結果を得たので，術後管理も含めて報告する．

Obesity is a risk factor of postoperative complications. We experienced 2 extremely obese patients：a 32-year-old male with coronary artery disease and a 75-year-old female with aortic valve stenosis. Their initial body weights were 133 kg and 88.5 kg, respectively, and their initial body mass indexes （BMIs） were both 41. Their BMIs were reduced to 35.5 and 35, respectively, after preoperative weight reduction. Off-pump coronary artery bypass grafting and aortic valve replacement were performed, respectively. After surgery, the non-invasive positive pressure ventilation （NPPV） support was effective, and their postoperative courses were uneventful. Preoperative weight reduction and NPPV are useful for extremely obese patients who undergo cardiac surgery.