2022, Vol. 5, Issue 2, Part A
Anaesthetic management of patient with severe aortic stenosis posted for Myomectomy: A case report
Author(s): R Mookambika and S Parthasarathy
Abstract: Aortic stenosis is a stenotic valvular heart disease with a fixed cardiac output state. The patients with such illness can come for non-cardiac surgeries. They pose significant challenges to the attending anesthesiologist. Here, we report a 45-year-old 65 kg female with significant aortic stenosis posted for myomectomy. She was a known case of significant aortic stenosis with an orifice of 1 sq.cm. She was symptomatic with NYHA class three symptoms. The patient had a difficult airway with Mallampatti class IV with stiff temporomandibular joints. The pulse rate was 70 / minute and regular with a blood pressure of 110/70mmHg. After explaining the pros and cons of General and regional anaesthesia, the patient accepted for a regional technique. A bilateral TAP block was administered with 20 ml of 0.25 % bupivacaine on each side. She was administered intrathecal fentanyl 50 µg with 0.5 ml of 0.5 % hyperbaric bupivacaine. Surgical anaesthesia was obtained and myomectomy was completed within 45 minutes. The blood loss was approximately 500 ml which was replaced. After an uneventful early postoperative period of six hours, she became hypotensive with a heart rate of 122/minute. An emergency ultrasound scan revealed a collection. A passive leg rising test was positive. She was again administered two more units of compatible blood. The rest of the postoperative period was uneventful and discharged on the seventh day. This case is reported for its extreme rarity and successful management.
DOI: 10.33545/26643766.2022.v5.i2a.346
Pages: 25-27 | Views: 653 | Downloads: 327
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How to cite this article:
R Mookambika, S Parthasarathy. Anaesthetic management of patient with severe aortic stenosis posted for Myomectomy: A case report. Int J Med Anesthesiology 2022;5(2):25-27. DOI: 10.33545/26643766.2022.v5.i2a.346
