Key result
Preoperative assessment, conduct of anesthesia, and comprehensive TEE examination are crucial for managing patients with hypertrophic cardiomyopathy undergoing surgery.
Provides a comprehensive overview of anesthetic and surgical considerations, including the critical role of intraoperative TEE, for patients with hypertrophic cardiomyopathy.
May inform HCM anesthesia protocols; leaves open optimal TEE strategies pending prospective validation.
Hypertrophic cardiomyopathy (HCM) poses many unique challenges regarding the conduct of anesthesia and surgery. Adequate preload, control of sympathetic stimulation, heart rate, and increased afterload are required to decrease the left ventricular outflow tract obstruction. Comprehensive intraoperative transesophageal echocardiography (TEE) examination confirms the diagnosis, elucidates the pathophysiology, and identifies the various anomalies of mitral valve apparatus and allows assessment of the adequacy of surgery. In this review, we focus on the preoperative assessment, conduct of anesthesia and comprehensive TEE examination of patients presenting for surgery with HCM. The various surgical options are extended myectomy and resection, plication and release.
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Varma et al. (2014) conducted a review in Hypertrophic cardiomyopathy (HCM). Anesthetic and surgical management was evaluated. Preoperative assessment, conduct of anesthesia, and comprehensive TEE examination are crucial for managing patients with hypertrophic cardiomyopathy undergoing surgery.
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