Anesthetic considerations in a patient with severe aortic stenosis for craniotomy

Severe aortic stenosis can pose a serious hazard for noncardiac surgery as patients with this condition have a high risk for developing perioperative cardiac complications. We describe the anesthetic management of a patient with a malignant brain tumor who was found to have severe aortic stenosis during preanesthetic evaluation. She underwent palliative balloon aortic valvuloplasty prior to surgery, and this combined with appropriate monitoring and drug therapy resulted in a satisfactory outcome. Adverse intraoperative events like hypotension and left ventricular failure occurred; however, these events were transient and responded to treatment.