Anesthetic management of a patient with bicuspid aortic valve and Hashimoto′s thyroiditis posted for abdominal hysterectomy

Abstract

Bicuspid aortic valve is the most common birth defect affecting the heart and is present in 1-2% of the population. The abnormal valve structure leads to turbulent flow, fibrosis, calcification, and aortic stenosis. Aortic stenosis increases perioperative morbidity and mortality. Anesthetic techniques that reduce systemic vascular resistance (regional neuraxial techniques) must be used with extreme caution. Hashimoto's disease or chronic thyroiditis or autoimmune thyroiditis is the most common cause of hypothyroidism in adults. Regional anesthesia is preferred in patients with hypothyroidism as recovery from general anesthesia may be delayed by hypothermia, respiratory depression, or slow drug biotransformation. This is a case report of anesthetic management of a middle-aged female with co-existing aortic stenosis, hypothyroidism, and fibroid uterus posted for abdominal hysterectomy.

Anaesthetic management of patient with severe aortic stenosis posted for Myomectomy: A case report

“…Hence this was an added advantage for us in already anemic patient. Hoyalchi et al [5] did a case report of a patient with severe aortic stenosis and hashimoto's thyroiditis posted for abdominal hysterectomy, epidural anesthesia was the choice of anaesthesia, which provided stable hemodynamics throughout the intraoperative and post operative period. Osaheni [2] studied TAP block for post operative myomectomy pain and found the time to first analgesia significantly reduced in TAP group indicating a somatic pain relief provided by the TAP block.…”