Careful perioperative anaesthetic management allows for successful noncardiac surgery and pacemaker repositioning in patients with severe dilated cardiomyopathy and very low ejection fraction.
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May support meticulous perioperative planning in severe cardiomyopathy; leaves open generalizability beyond this single case.
The anaesthetic management of a patient with Dilated Cardiomyopathy (DCM) undergoing noncardiac surgery is always a challenge to the anaesthesiologist as DCM is most commonly complicated by progressive congestive heart failure. Chronic heart failure is one of the indications of atrio-biventricular pacemaker. We report a case of DCM with severe left ventricular dysfunction with ejection fraction 15% with permanent pacemaker posted for modified radical mastectomy (MRM) and repositioning of pacemaker to prevent pacemaker failure due to radiation as postoperative radiotherapy was planned. The present case was successfully managed with well planned perioperative care.
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A 2006 study studied this question.
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