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Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
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[Patient whose surgery was postponed due to complete atrioventricular block on arrival at operating theater]

Azusa Kato1, Toshiya Koitabashi, Takao Kato

  • 1Department of Anesthesiology, Ichikawa General Hospital, Tokyo Dental College, Ichikawa 272-8513.

Masui. the Japanese Journal of Anesthesiology
|June 30, 2011
PubMed

Insights

A patient with pre-existing heart conditions developed complete atrioventricular block before hip surgery. The surgery was postponed for pacemaker insertion, ensuring patient safety and successful outcomes.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Anesthesiology

Background:

  • An 86-year-old female with reduced cardiac function was scheduled for hip fracture surgery.
  • Preoperative ECG revealed left bundle branch block, first-degree AV block, left axis deviation, and bigeminy.

Observation:

  • On operating theater arrival, the patient's ECG showed a progression to complete atrioventricular block.
  • This condition is classified as an 'active cardiac condition' per ACC/AHA guidelines.

Findings:

  • Surgery was postponed for cardiac evaluation and treatment.
  • Complete atrioventricular block persisted for a week despite medication adjustments.
  • A permanent pacemaker was successfully implanted.

Implications:

  • The patient underwent hip surgery two weeks post-pacemaker insertion without complications.
  • This case highlights the importance of perioperative cardiovascular evaluation and management in elderly patients with cardiac comorbidities.
  • Timely intervention with a permanent pacemaker can enable necessary surgical procedures in high-risk patients.

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