Non Cardiac Surgery in a patient with Triple Vessel Disease and LBBB -- Case Report

Amte, Rahul; Khanale, Manish; Nair, Abhijit S.
January 2014
Indian Anaesthetists' Forum;Jan2014, Vol. 15 Issue 1, p1
Academic Journal
Case Study
Anaesthetising a patient with severe coronary artery disease for non-cardiac surgery especially one who has not undergone any revascularization in the form of angioplasty or coronary artery bypass grafting is very challenging. Preoperative risk stratification, optimisation, judicious selection of anaesthesia technique, perioperative management of pain and intravascular volume status are crucial factors in avoiding adverse outcomes in such patients. We describe successful anaesthesia management of a patient with triple vessel disease recommended for CABG, who underwent per-anal excision of a rectal adenoma under regional anaesthesia. We've also discussed the ECG criteria for diagnosis of LBBB and the diagnosis of myocardial infarction in presence of LBBB as the intrinsic rhythm.


Related Articles

  • Coronary artery bypass surgery in the presence of cerebrospinal fluid rhinorrhea. Rawat, Rajinder Singh; Mehta, Yatin; Trehan, Naresh; Gupta, Aditya // Annals of Cardiac Anaesthesia;Oct-Dec2013, Vol. 16 Issue 4, p283 

    A seventy eight year old male patient was admitted in our hospital with headache, vomiting, irritability and confusion. Initially he was diagnosed as a case of pyogenic encephalitis. Further investigations revealed that patient had cerebrospinal fluid rhinorrhea and coronary artery disease. He...

  • Iatrogenic Left Main Coronary Ostial Stenosis after a Bentall Procedure in an Asymptomatic Young Man. Bernelli, Chiara; Bezante, Gian Paolo; Brunelli, Claudio; Balbi, Manrico // Texas Heart Institute Journal;2012, Vol. 39 Issue 3, p393 

    Coronary ostial stenosis is a rare but potentially fatal sequela of aortic surgery. The clinical presentation can include acute coronary syndromes, ventricular arrhythmias, congestive heart failure, or sudden death. Herein, we present what we believe is the first reported case of asymptomatic...

  • Perioperative intra-aortic balloon counterpulsation in a patient with myocardium at risk undergoing urgent noncardiac surgery. Nebelsiek, Tim; Weis, Florian; Angele, Martin; Brettner, Florian // Annals of Cardiac Anaesthesia;Apr-Jun2015, Vol. 18 Issue 2, p242 

    We are presenting the case of a 76-year-old female scheduled for major abdominal surgery. Her past medical history was remarkable for a three-vessel coronary artery disease, with a severely impaired left ventricular function. She had already undergone complex coronary artery bypass surgery....

  • Depression after CABG: a prospective study. Rodrigues Sampaio Nunes, Joana Kátya Veras; de Figueiredo Neto, José Albuquerque; de Sousa, Rosângela Maria Lopes; de Castro Costa, Vera Lívia Xavier; de Maria Araújo Mendonça Silva, Flor; da Hora, Ana Flávia Lima Teles; da Silva, Edna Lúcia Coutinho; Branco Reis, Lívia Mariane Castelo // Brazilian Journal of Cardiovascular Surgery;Oct-Dec2013, Vol. 28 Issue 4, p491 

    Introduction: Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. Objective: To assess the impact of revascularization on symptoms of depression in...

  • A rare cause of congestive heart failure after seven years of open heart surgery: Organized intrapericardial hematoma. Velibey, Yalçın; Şahin, Sinan; Altay, Servet; Bakshaliyev, Nijat; Tusun, Eyüp; Ünal, Sennur; Eren, Mehmet // Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi;Mar2014, Vol. 14 Issue 2, p205 

    A case study of a 60-year-old male who had undergone triple coronary artery bypass grafting 7 years prior with progressive shortness of breath and generalized edema over the prior two months is presented. Topics discussed include delayed hemopericardium, constrictive pericarditis and heart...

  • Myocardial protection with prophylactic oral metoprolol during coronary artery bypass grafting surgery: evaluation by troponin I. Rossi Neto, João Manoel; Gun, Carlos; Ramos, Rui Fernando; de Almeida, Antonio Flavio Sanchez; Issa, Mario; Amato, Vivian Lener; Dinkhuysen, Jarbas J.; Piegas, Leopoldo Soares // Brazilian Journal of Cardiovascular Surgery;Oct-Dec2013, Vol. 28 Issue 4, p449 

    Introduction: Biochemical markers of myocardial injury are frequently altered after cardiac surgery. So far there is no evidence whether oral beta-blockers may reduce myocardial injury after coronary artery bypass grafting. Objective: To determine if oral administration of prophylactic...

  • Phlegmasia Cerulea Dolens after Coronary Artery Bypass Surgery: What Should We Know. Kang-Hoon Lee; Hyun-Suk Park; Kilsoo Yie // Korean Journal of Thoracic & Cardiovascular Surgery;Feb2014, Vol. 47 Issue 1, p43 

    Phlegmasia cerulea dolens (PCD) is one of the most critical disorders of acute deep vein thrombosis in that it can cause permanent disability secondary to the compartment syndrome. Although several etiological factors have been proposed, PCD after coronary artery bypass surgery is extremely rare...

  • Coronary stent entrapment. Macovei, Liviu Gheorghe; Presura, Razvan Mihai; Anghel, Larisa; Stanciu, Bogdan; Lovin, Nicusor; Haret, Roberto; Arsenescu-Georgescu, Catalina // Advances in Interventional Cardiology;2014, Vol. 10 Issue 3, p216 

    A 64-year-old woman with a history of coronary artery bypass and coronary angioplasty with unexpanded stent entrapment blocked in the circumflex coronary artery and left main is now presenting with crescendo angina pectoris. The Department of Cardiovascular Surgery established that a new...

  • Combined coronary and femoral revascularization for the treatment of hypoplastic aortoiliac syndrome: Report of a case. Ito, Hisato; Yamamoto, Kiyohito; Hiraiwa, Takane // Surgery Today;Dec2008, Vol. 38 Issue 12, p1120 

    The coronary artery and aortoiliac occlusive disease frequently coexist and in relatively rare instances, a complication of hypoplastic aortoiliac syndrome (HAIS) may occur. We herein present our experience with a 51-year-old female patient with HAIS and concomitant coronary artery disease. She...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics