BackgroundCongenital factor VII (FVII) deficiency is a rare autosomal recessive coagulation disorder that is characterized by prolongation of prothrombin time. Recombinant activated FVII (rFVIIa) is widely used in the management of bleeding in patients with congenital FVII deficiency. We experienced anesthetic management of a patient with congenital FVII deficiency who was scheduled for laparoscopic colectomy using rFVIIa.Case presentationWe report a 67-year-old man with rectal cancer who was diagnosed with congenital FVII deficiency. He was scheduled for laparoscopic colectomy. General anesthesia was performed with propofol, remifentanil, and rocuronium without epidural anesthesia. For coagulation management, 1 mg of rFVIIa was intravenously administered before starting surgery. During surgery, FVII activity and prothrombin time-international normalized ratio (PT-INR) were maintained to be above 10 % and within the normal range (0.8–1.2), respectively. The surgery was uneventfully completed.ConclusionsWe reported successful management of a patient with congenital FVII deficiency undergoing laparoscopic colectomy with monitoring of FVII activity and/or PT-INR.

Background Cannulation of a central venous catheter is sometimes associated with serious complications. When arterial cannulation occurs, attention must be given to removal of a catheter. Case presentation A 62-year-old man was planned for emergency thoracic endovascular aortic repair. After the induction of anesthesia, a central venous catheter was unintentionally inserted into the right subclavian artery. We planned to remove the catheter. Since we considered that surgical repair would be highly invasive for the patient, we decided to remove it using a percutaneous intravascular stent. A stent was inserted through the right axillary artery. The stent was expanded immediately after the catheter was removed. Post-procedural angiography revealed no leakage from the catheter insertion site and no occlusion of the right subclavian and vertebral arteries. There were no obvious hematoma or thrombotic complications. Conclusions A catheter that has been misplaced into the right subclavian artery was safely removed using an intravascular stent.

The purpose of this study was to compare the temperature estimated by TTP (TTTP) and nasopharyngeal temperature (TNASO) under hypothermic cardiopulmonary bypass. We examined the correlation and agreement between TNASO and TTTP. We identified 9 adult patients in whom TTTP and TNASO had been measured simultaneously during anesthesia for elective cardiovascular surgery. We compared TNASO with TTTP before CPB, during CPB with cooling TNASO, during CPB with stable low TNASO, during CPB with re-warming TNASO, and after CPB. Correlations between absolute values of TNASO and TTTP were determined by linear regression. Bland-Altman analysis was used to examine the agreement between TNASO and TTTP. TTTP was highly correlated with TNASO in all 5 periods (p＜0.01) .Bland-Altman plots showed the 95％ LOA was not within ±0.5℃ in all 5 periods. Good agreement between the two methods of measurement was not seen. TTTP and TNASO have a good correlation but have poor agreement under hypothermic cardiopulmonary bypass.