Anesthetic Management of an Elderly Patient with Dilated Cardiomyopathy and Hypothyroidism for Inter-Trochanteric Fracture

2019 ◽  
Vol 9 (3) ◽  
pp. 97-99
Author(s):  
Deepika Subedi ◽  
Diptesh Aryal ◽  
Anil Shrestha
Keyword(s):  
Elderly Patient ◽  
Cardiac Surgery ◽  
Dilated Cardiomyopathy ◽  
Spinal Anesthesia ◽  
Surgical Repair ◽  
Anesthetic Management ◽  
Trochanteric Fracture ◽  
Anaesthetic Management ◽  
Left Ventricular ◽  
Perioperative Morbidity

   Dilated cardiomyopathy is a primary myocardial disease charac­terized by left ventricular or biventricular dilation and impaired contractility. The anesthetic management of a patient with dilat­ed cardiomyopathy undergoing a non-cardiac surgery is always challenging and may be associated with high mortality. Further­more, perioperative morbidity becomes more frequent in the el­derly with steep increases after the age of 75. We are reporting the successful anaesthetic management of a 93 years old patient with severe dilated cardiomyopathy planned for surgical repair of inter-trochanteric fracture under combined spinal anesthesia.

scholarly journals Prevalence of co-morbidities among adult patients presented for open heart surgery and the implication on convalescence period

2017 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Hayel Al Adwan ◽  
Ashraf Fadel ◽  
Yanal F. Al Naser ◽  
Abdallah Al Qaysi ◽  
Rami Qsous ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Anesthetic Management ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Adult Patients ◽  
Open Heart ◽  
Previous Myocardial Infarction ◽  
Icu Discharge

Background: Improvements in perioperative medical care, anesthetic management, surgical and myocardial protection techniques made cardiac surgery feasible in the high risk surgical patients. The aim of the study was to determine the prevalence of comorbidities in adult patients undergoing open heart surgery and to evaluate their implications on recovery profile.Methods: This randomized retrospective observational study of 100 adult patients presented for heart surgery for different pathologies took place at Queen Alia heart Institute in the period of time between February 2013 and June 2014. Patients' data was collected in forms, tabulated and retrospectively analyzed. Patients' demographics, co-morbidities and type of surgery were recorded. Risk stratification models (ASA-American Society of Anesthesiology and EUROSCORE 2- European system for cardiac operative risk evaluation) were used. Time of extubation, ICU discharge and hospital discharge was recorded with each patient.Results: Age of patients ranged from 18 to 77 years (mean±SD: 58±12). 83% of patients were male and 17% were female. 80 patients were presented for CABG and 20 patients for heart valve(s) surgery. BMI (body mass index, mean±SD) was 28.9±4.6 kg/m². The prevalence of smoking was 56% (6 times higher among males (64%), in comparison to females (12%). Hypertension was prevalent in 72% of patients; diabetes was present in 53%, respiratory disease in 30%, previous myocardial infarction in 23%, 37% of patients had left ventricular impairment, renal impairment in 6%, renal failure in 2% and previous stroke in 2%. EUROSCORE values ranged between 0.5 to 5.3 % (mean 1.4%). ASA grades ranged from 2 to 4 (85% of patients were grade 3). 5% of surgeries were emergent. Average operative time was 248±47 minutes (mean±SD). 30% of patients needed inotropic support and 6% needed intra-aortic balloon. Mean time in the intensive care was 43.2±28.8 hours (mean±SD).Conclusions: There is a high prevalence of co-morbidities in patients presented for cardiac surgery. Most common associated diseases were hypertension, obesity, smoking, previous myocardial infarction and diabetes; which are all well known risk factors of ischemic heart disease. Preoperative risk scoring is of paramount importance.

scholarly journals Anaesthetic management of a case of congenitally corrected transposition of great arteries for non cardiac surgery: A case report

2021 ◽  
Vol 8 (2) ◽  
pp. 341-344
Author(s):  
Heena D Pahuja ◽  
Charuta P Gadkari ◽  
Neha G Wakode ◽  
Anjali R Bhure
Keyword(s):  
Cardiac Surgery ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Anaesthetic Management ◽  
Left Ventricular ◽  
Complex Congenital Heart Disease ◽  
Associated Anomalies ◽  
Transposition Of Great Arteries ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

Congenitally corrected transposition of the great arteries (CCTGA) is a rare form of congenital heart diseases, present with or without associated anomalies. It is a complex congenital heart disease with both atrioventricular and ventriculoarterial discordance. Such patients tend to develop systemic ventricular dysfuction with the stress of surgery. Patients with CCTGA are usually diagnosed at early stages of life due to associated anomalies, but they may even remain asymptomatic till later decades of their life. Literature search revealed very few reported cases of anaesthetic management of such high risk cases for non cardiac surgery. These patients have the tendency to develop cardiac dysrhythmias and left ventricular failure during intraoperative and postoperative period. We report anaesthetic management of a case of a 24 years old male with the congenitally corrected transposition of great arteries(CCTGA) who was operated for fracture left distal radius and ulna and right sided galeazzi fracture.

scholarly journals Hypertrophied Papillary Muscle causing Mid Cavity Left Ventricular Obstruction after Cardiac Surgery

2015 ◽  
Vol 3 (1) ◽  
pp. 32-34
Author(s):  
Ajay Bahl ◽  
Shyam Singh Thingnum
Keyword(s):  
Elderly Patient ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Papillary Muscle ◽  
Muscle Hypertrophy ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Atypical Presentation ◽  
Contractile State

ABSTRACT A rare cause of mid cavity left ventricular obstruction can be a hypertrophied and/or a malformed papillary muscle. Hypertrophy of papillary muscle can be atypical presentation of hypertrophic obstructive cardiomyopathy. Most of these patients do not have a resting gradient, but a dynamic gradient can occur in hypovolumia or increased contractile state. We present a case of elderly patient who had a hypertrophied anterolateral papillary muscle and developed mid left ventricular obstruction after weaning the patient from cardiopulmonary bypass. How to cite this article Dutta V, Raj R, Bahl A, Thingnum SS, Puri GD. Hypertrophied Papillary Muscle causing Mid Cavity Left Ventricular Obstruction after Cardiac Surgery. J Perioper Echocardiogr 2015;3(1):32-34.

scholarly journals Left Ventricular Rupture during Balloon Mitral Valvuloplasty

2016 ◽  
Vol 1 (1) ◽  
pp. 28-29
Author(s):  
Tazeen Sarguroh ◽  
Dipti Kotwani ◽  
Shakuntala Basantwani ◽  
Bharati Tendolkar
Keyword(s):  
Cardiac Tamponade ◽  
Mitral Stenosis ◽  
Surgical Repair ◽  
Anesthetic Management ◽  
Left Ventricular ◽  
Mitral Valvuloplasty ◽  
Replacement Surgery ◽  
Ventricular Rupture ◽  
Left Ventricular Rupture ◽  
Valve Replacement Surgery

ABSTRACT Balloon mitral valvuloplasty (BMV) is a viable alternative to valve replacement surgery in patients with mitral stenosis. One of the rare complications of the procedure requiring immediate resuscitation and surgical repair is cardiac tamponade due to ventricular rupture. We report the anesthetic management of a 38 year old female with hemopericardium during BMV due to left ventricular rupture. How to cite this article Sarguroh T, Kotwani D, Basantwani S, Tendolkar B. Left Ventricular Rupture during Balloon Mitral Valvuloplasty. Res Inno Anaesth 2016;1(1):28-29.

Left Ventricular Aneurysm in a Child After Recovering From Dilated Cardiomyopathy

2020 ◽  
Vol 11 (4) ◽  
pp. 515-517
Author(s):  
Ramiro Lizano-Santamaria ◽  
Mitchell Cohen ◽  
Melany Atkins ◽  
Lucas Collazo
Keyword(s):  
Dilated Cardiomyopathy ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Left Ventricular Aneurysm ◽  
Ventricular Aneurysm ◽  
Initial Management

Left ventricular aneurysms are extremely rare in children. A child developed an aneurysm a year after recovering from idiopathic dilated cardiomyopathy. The initial management was conservative. After several years and due to aneurysm enlargement and other complications, the patient underwent successful aneurysm surgical repair with left ventricular aneurysmorrhaphy. We describe our experience treating this child during the course of this disease.

scholarly journals Anaesthetic Management of a Parturient with Dilated Cardiomyopathy

2019 ◽  
Vol 18 (1) ◽  
pp. 52-53
Author(s):  
Alak Nandy ◽  
Rajat Sanker Roy Biswas ◽  
Farah Naz Mabud ◽  
Aklima Sultana
Keyword(s):  
Case Report ◽  
Left Ventricular Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Systolic Dysfunction ◽  
Anaesthetic Management ◽  
Caesarian Section ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Contractility ◽  
Ventricular Ejection Fraction

Dilated Cardiomyopathy (DCM) is a form of cardiomyopathy characterized by left ventricular or biventricular dilatation and impaired ventricular contractility. This results in systolic dysfunction of the heart with decreased left ventricular ejection fraction and progressive cardiac failure. This case report describes the successful anaesthetic management of a parturient with Dilated cardiomyopathy underwent Caesarian section under spinal anaesthesia. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 52-53

Anaesthetic management of a patient with dilated cardiomyopathy posted for non-cardiac surgery

2016 ◽  
Vol 5 (3) ◽  
pp. 184
Author(s):  
MHanumantha Rao ◽  
M Madhusudan ◽  
K Aditya ◽  
T Rajasekhar ◽  
SM Nayyara Banu ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Dilated Cardiomyopathy ◽  
Anaesthetic Management
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