Why the study?
Aneurysmal surgeries carry high risks of fatal perioperative complications that are exaggerated by co-existing HCM, in which perioperative factors can precipitate life-threatening left ventricular outflow tract obstruction.
Dexmedetomidine infusion without a loading dose provided stable hemodynamics and prevented complications during emergency intracranial aneurysm clipping in a patient with hypertrophic cardiomyopathy.
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Case report suggests tailored management for aneurysmal surgery with HCM; leaves open optimal protocols in this rare scenario.
Aneurysmal surgeries are high-risk procedures due to potential for occurrence of fatal perioperative complications. This risk is exaggerated in the presence of co- existing hypertrophic cardiomyopathy (HCM). It involves asymmetrical hypertrophy of left ventricle with mitral valve dysfunction, leading to left ventricular outflow tract obstruction. Various perioperative factors may precipitate this obstruction resulting in life-threatening consequences. We report the management of a patient with HCM undergoing anterior communicating artery aneurysm clipping and discuss the anesthetic concerns. Comprehensive approach with careful drug selection, vigilant monitoring, and preparedness for complications enabled patient safety and a good neurological outcome.
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Duggal et al. (2020) studied this question.
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