Key result
Careful anesthetic management and interdisciplinary collaboration facilitate successful surgery in a severe HOCM patient.
Why the study?
HOCM causes LVOTO predisposing patients to systolic and diastolic dysfunction, arrhythmias, and sudden cardiac death during the perioperative period.
Case Report (n=1)
Careful multidisciplinary anesthetic management and perioperative monitoring can lead to successful surgical outcomes in patients with severe hypertrophic obstructive cardiomyopathy undergoing non-cardiac surgery.
Hypertrophic obstructive cardiomyopathy (HOCM) is a genetically mediated disease causing left ventricular outflow tract obstruction (LVOTO) predisposing the patient to systolic and diastolic dysfunction leading to arrhythmias and sudden cardiac deaths in the perioperative period. This case report describes the anesthetic management of a 76-year-old female posted for a semi-emergent three level lumbar canal decompression with severe HOCM with dynamic LVOTO with an initial resting gradient >70 mmHg, noninsulin-dependent diabetes mellitus, bronchial asthma, deep-vein thrombosis, and hypothyroidism as comorbidities. Preoperative evaluation of the risks, cardiac optimization, interdisciplinary shared decision making, preoperative invasive monitoring, preanesthetic placement of defibrillator pads, careful titration of anesthetic agents, with meticulous perioperative monitoring, and perioperative intensive care collaboration contributed to a successful outcome.
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Monteiro et al. (2021) conducted a case report in Hypertrophic obstructive cardiomyopathy (HOCM) (n=1). Anesthetic management (preoperative optimization, invasive monitoring, careful titration of agents) was evaluated on Successful outcome. Careful anesthetic management, including preoperative optimization, invasive monitoring, and interdisciplinary collaboration, contributed to a successful surgical outcome in a patient with severe HOCM.
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