Use of a Minimally Invasive Cardiac Output Monitor to Optimise Haemodynamics in a Patient with Mitral Valve Disease Undergoing Cerebrovascular Surgery
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 3
Abstract
Patients with mitral valve disease undergoing cerebrovascular surgery face increased inherent risks due to their associated cardiac comorbidities. As such, the anaesthetic management of such patients is distinctly challenging. Simultaneous consideration of both the cerebrovascular and underlying cardiac conditions determines key anaesthetic issues, as fluids and vasopressors or inotropes need to be titrated according to haemodynamic variables in order to optimise cerebral blood flow without compromising cardiac function. We report a 45-yearold female patient with mild mitral stenosis and moderate-to-severe mitral regurgitation who presented to the Khoula Hospital, Muscat, Oman, in 2016 following a ruptured anterior communicating artery aneurysm requiring urgent surgical intervention. As highlighted in this case, the VolumeView EV1000™ (Edwards Lifesciences, Irvine, California, USA) system is a minimially invasive haemodynamic monitor that can help immensely in the perioperative management of such patients.
Authors and Affiliations
Ali M. Al-Mashani| Departments of Neurosurgery, Intensive Care Unit & Pain Management, Khoula Hospital, Muscat, Oman, Niranjan D. Waje| Department of Cardiac Anaesthesia, Royal Hospital, Muscat, Oman, Neeraj Salhotra| Departments of Neurosurgery, Intensive Care Unit & Pain Management, Khoula Hospital, Muscat, Oman, Samaresh Das| Departments of Anaesthesia, Intensive Care Unit & Pain Management, Khoula Hospital, Muscat, Oman, Neelam Suri| Departments of Anaesthesia, Intensive Care Unit & Pain Management, Khoula Hospital, Muscat, Oman, Rashid A. Al-Sheheimi| Anaesthesia Residency Programme, Oman Medical Speciality Board, Muscat, Oman, Nilay Chatterjee| Departments of Anaesthesia, Intensive Care Unit & Pain Management, Khoula Hospital, Muscat, Oman
Genotypes and allele frequencies of angiotensin converting enzyme (ACE) insertion/deletion polymorphism among Omanis
Objective: To describe the angiotensin converting enzyme (ACE) genotype frequencies among Omani Arabs. Method: A polymerase chain reaction (PCR) test, based on separation of different size DNA fragments, was developed t...
Atypical Presentations of Respiratory Syncytial Virus Infection Case series
Te respiratory syncytial virus (RSV) usually causes a lower respiratory tract infection in affected patients. RSV has also been infrequently linked to extrapulmonary diseases in children. We report four children who h...
Arterial Resistance in Late First Trimester as a Predictor of Subsequent Pregnancy-Related Hypertension
Objectives: Tis study aimed to examine the association between indicators of arterial resistance occurring late in the frst trimester and the subsequent development of pregnancy-related hypertension. Methods: Tis study...
The Emergence of Surgical Expertise in the Care of the Critically Injured Patient in the Arab Gulf States
Polymethyl Methacrylate (Perspex) Line Pattern Phantom : A New Gamma Camera Test Pattern for Assessment of Extrinsic Resolution and Linearity
Objective: To evaluate the newly designed polymethyl methacrylate (Perspex) line pattern phantom (PLPP) for testing extrinsic resolution and linearity of gamma camera. Method: The phantom was made of 10 mm thick Perspex...