Key result
Awake fiberoptic intubation and careful hemodynamic management enabled successful off-pump CABG in a high-risk patient with a difficult airway due to prior oral cancer treatment.
Why the study?
To highlight the need to formulate a difficult airway pathway for post-cancer treated patients scheduled for high-risk cardiac surgery.
Case Report (n=1)
No
Awake fiberoptic intubation in cancer survivors with compromised cardiac status requires careful hemodynamic management to prevent decompensation during cardiac surgery.
Supports tailored airway strategies in select high-risk cases; hypothesis-generating and should not yet change practice.
Aims and objectives: To highlight the need to formulate a difficult airway pathway for post-cancer treated patients posted for high-risk cardiac surgery. Airway protection is mandatory for surgery. Cancer patients, especially oral, are difficult airway candidates as are cardiac patients. Cancer patients pose anatomical challenges, while cardiac patients pose physiological and/or anatomical challenges. However, when a cancer-treated patient comes for cardiac surgery with compromised cardiac status, the risk and complication probability increases. With cardiac disease and cancer being interrelated and incidence rising with newer treatment modalities, cases are varied requiring impromptu innovation. We present a case of post-surgery, chemo, and radiotherapy oral cancer posted for coronary artery bypass graft (CABG) with left main disease and low ejection fraction.
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Kaiche et al. (2021) conducted a case report in Coronary artery disease with difficult airway post-oral cancer treatment (n=1). Awake fiberoptic intubation and off-pump CABG was evaluated on Successful intubation and surgical recovery. Awake fiberoptic intubation and careful hemodynamic management enabled successful off-pump CABG in a high-risk patient with a difficult airway due to prior oral cancer treatment.
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