Use of a Minimally Invasive Cardiac Output Monitor to Optimise Haemodynamics in a Patient with Mitral Valve Disease Undergoing Cerebrovascular Surgery

Abstract

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.

Utility of Minimally Invasive Cardiovascular Monitoring in the High-Risk Patient Undergoing Radical Cystoprostatectomy: A Case Report

“…However, few studies address the efficacy of non-invasive hemodynamic monitors in patients with significant valvulopathies. Case reports describe using the MICM for management of severe aortic stenosis during hip surgery and severe MR during cerebral aneurysm surgery [11,12]. However, recent randomized trials using these devices on patients undergoing large abdominal surgeries specifically excluded patients with moderate to severe valve disease [13].…”