Anesthetic Challenges in the Management of Intracranial Aneurysm Clipping in a Patient with Hypertrophic Cardiomyopathy

Sakshi Duggal; Priyanka Khurana; Pragati Ganjoo; Nilima Das

doi:10.1055/s-0040-1716425

Journal of Neuroanaesthesiology and Critical Care, Table of Contents

CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2022; 09(01): 038-040
DOI: 10.1055/s-0040-1716425

Case Report

Anesthetic Challenges in the Management of Intracranial Aneurysm Clipping in a Patient with Hypertrophic Cardiomyopathy

Authors

Sakshi Duggal

¹Department of Anaesthesiology and Intensive Care, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
Priyanka Khurana

²Department of Anaesthesiology and Intensive Care, Neuroanaesthesia Unit, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
Pragati Ganjoo

¹Department of Anaesthesiology and Intensive Care, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
Nilima Das

¹Department of Anaesthesiology and Intensive Care, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India

Abstract

Aneurysmal surgeries are high-risk procedures due to potential for occurrence of fatal perioperative complications. This risk is exaggerated in the presence of co- existing hypertrophic cardiomyopathy (HCM). It involves asymmetrical hypertrophy of left ventricle with mitral valve dysfunction, leading to left ventricular outflow tract obstruction. Various perioperative factors may precipitate this obstruction resulting in life-threatening consequences. We report the management of a patient with HCM undergoing anterior communicating artery aneurysm clipping and discuss the anesthetic concerns. Comprehensive approach with careful drug selection, vigilant monitoring, and preparedness for complications enabled patient safety and a good neurological outcome.

Keywords

hypertrophic cardiomyopathy - intracranial aneurysm - anesthesia

Full Text

References

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