A Case Report of Spinal Anesthesia for Cerclage Placement in the Setting of Severe Hypertrophic Obstructive Cardiomyopathy. Issue 4 (11th April 2023)

• Record Type: Journal Article
• Authors: Hussey, Patrick T.; Hussey, Hanna; Egbaria, Jamal; Landau, Ruth; Townsley, Matthew M.
• Is Part Of: A & A practice. Volume 17:Issue 4(2022)
• Page Start: e01675
• Publication Date: 2023-04-11
• Subjects: Analgesia -- Periodicals; Analgesia -- Case studies -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology -- Case studies -- Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000001675
• Languages: English
• ISSNs: 2575-3126

Abstract

Abstract : Neuraxial anesthesia is preferred over general anesthesia in obstetric patients to avoid airway manipulation, aspiration, and maternal-fetal transfer of medications; however, a sudden sympathetic block is generally avoided in patients with hypertrophic obstructive cardiomyopathy (HOCM). The case of a 31-year-old G2P0010 with HOCM with severe resting left ventricular outflow tract (LVOT) obstruction and systolic anterior motion of the mitral valve undergoing a cerclage under choroprocaine spinal anesthesia is presented. Risks and benefits of general versus neuraxial anesthesia, and epidural versus spinal anesthesia, in this specific setting are reviewed.