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329777

Anaesthetic management of a case of large ASD with severe pulmonary hypertension—case presentation

Article

Last updated: 05 Jan 2025

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Abstract

Background
Atrial septal defect is the most common acyanotic congenital cardiac anomaly in the adults after bicuspid aortic valve with high prevalence in females. Major challenges in the management of large ASD with severe pulmonary hypertension includes hypoxemia, hypercarbia, hypothermia leading to reversal of shunt (Eisenmenger syndrome), fatal arrhythmias and congestive heart failure.
Case presentation
We report the successful management of the case of 44-year-old female patient with large ASD and severe pulmonary arterial hypertension posted for total abdominal hysterectomy with salpingectomy. She had history of palpitations with exertional dyspnoea and history of abnormal uterine bleeding with failed medical treatment. Echocardiography showed large OS-ASD (24 mm) with left to right shunt, moderate TR, severe PAH with estimated RVSP 60 mmHg, LVEF 50% and grossly dilated RA/RV. She underwent total abdominal hysterectomy with salpingectomy under regional anaesthesia with prophylactic use of adrenaline infusion.
Conclusions
Cardiac patients for non-cardiac surgery can be managed under regional anaesthesia.

DOI

10.1186/s42077-022-00232-3

Keywords

Atrial Septal Defect, Abdominal hysterectomy, pulmonary artery hypertension, Echocardiography, Case presentation

Authors

First Name

Vikram

Last Name

Madaan

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Rekha

Last Name

Gupta

MiddleName

-

Affiliation

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Email

guptarekha19.rg@gmail.com

City

-

Orcid

-

Volume

14

Article Issue

1

Related Issue

44741

Issue Date

2022-01-01

Receive Date

2022-03-10

Publish Date

2022-03-18

Print ISSN

1687-7934

Online ISSN

2090-925X

Link

https://asja.journals.ekb.eg/article_329777.html

Detail API

https://asja.journals.ekb.eg/service?article_code=329777

Order

329,777

Publication Type

Journal

Publication Title

Ain-Shams Journal of Anesthesiology

Publication Link

https://asja.journals.ekb.eg/

MainTitle

Anaesthetic management of a case of large ASD with severe pulmonary hypertension—case presentation

Details

Type

Article

Created At

20 Dec 2024