重症大動脈弁狭窄症合併大腿骨骨折の周術期管理計画を麻酔科が中心となって立案した1症例

Anesthesiologists’ Leading Role in Perioperative Management of Concomitant Acute Hip Fracture with Severe Aortic Stenosis：A Case Report

要旨

　術前検査で重症大動脈弁狭窄症の合併が判明した大腿骨頸部骨折の患者に対して，麻酔科が周術期管理計画の立案から関与し，良好な転帰を得た症例を経験した。治療方針を決定するうえで明確なガイドラインはなく，各疾患の周術期経過や治療の順番による利点および欠点を各科と協議して周術期管理を行った。

　Management of hip fracture with asymptomatic severe aortic stenosis（AS）is challenging. There is a lack of definite guidelines for concomitant acute hip fracture with severe AS. As a result, there is a need to predict perioperative progress of each disease and to devise the best management strategy for individual patient. Here, we present a case of an elderly hip fracture patient with asymptomatic severe AS. As perioperative specialists, we anesthesiologists took a leading place among perioperative surgical teams in comparing pros and cons of some treatment options and in making management plan of the patient.