The role of intraoperative transesophageal echocardiographic monitoring in a patient with hypertrophic cardiomyopathy undergoing laparoscopic surgery.
Hypertrophic cardiomyopathy (HCM) presents a significant perioperative challenge. Anesthetic drugs, patient positioning, and surgical technique can provoke worsening left ventricular outflow tract obstruction and hemodynamic deterioration. In this case report, we present the perioperative management of a 70-year-old male with a history of HCM who underwent a robotic laparoscopic prostatectomy. Discussion focuses on the utilization of echocardiographic guidance in the care of patients with HCM undergoing noncardiac surgery, as well as the pathophysiology of laparoscopic insufflation and its effects on left ventricular outflow tract obstruction in HCM.
Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Durham, NC, 27710, USA. Electronic address: Stephen.gregory@dm.duke.edu.
Stephen H
SH
Gregory
Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Durham, NC, 27710, USA. Electronic address: Michael.fierro@dm.duke.edu.
Michael A
MA
Fierro
D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D017548:Echocardiography, Transesophageal; D006801:Humans; D007327:Insufflation / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects; D014694:Ventricular Outflow Obstruction / Q000503:physiopathology
Anesthesia; Cardiomyopathy; Echocardiography; Hypertrophic; Laparoscopy; Transesophageal