Hypertrophic cardiomyopathy surgery: Perioperative anesthetic management with two different and combined techniques

Area of Science:

• Cardiology
• Cardiac Surgery
• Anesthesiology

Background:

• Hypertrophic cardiomyopathy (HOCM) is a prevalent genetic heart condition and a leading cause of sudden cardiac death.
• Extended transaortic septal myectomy is the gold standard surgical intervention for HOCM.
• Understanding HOCM pathophysiology is critical for optimizing intraoperative anesthetic management.

Observation:

• A case study involving a 68-year-old woman undergoing elective hypertrophic cardiomyopathy surgery is presented.
• HOCM poses significant risks for severe intraoperative hemodynamic instability.
• Anesthetic management is paramount for patient safety during HOCM surgery.

Findings:

• Intraoperative transesophageal echocardiography (TEE) provides crucial real-time cardiac imaging.
• Direct measurement of the left ventricular outflow tract (LVOT) gradient offers vital hemodynamic data.
• The combined use of TEE and LVOT gradient measurement enhances surgical decision-making.

Implications:

• Optimized anesthetic strategies can mitigate risks associated with HOCM surgery.
• TEE and LVOT gradient monitoring are essential tools for successful septal myectomy.
• This approach ensures improved patient safety and surgical outcomes in hypertrophic cardiomyopathy cases.