General anesthesia for bowel obstruction surgery in an elderly patient with severe mitral valve regurgitation, heart failure, atrial fibrillation and co-morbidity diseases

Ngo Xuan Ty1, Nguyen Ngoc Thach1,, Lam Ngoc Tu1, Nguyen Van Quynh2, Ninh Thi Kim Oanh3
1 103 Military Hospital
2 Le Huu Trac National Burn Hospital
3 HaNoi Medical University

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Abstract

General anesthesia for non-cardiac surgery in elderly patients with cardiovascular disease and co-morbidity diseases is a difficult problem for anesthesiologists because not only the physiology of patients and pharmacokinetics of drugs are changed but also the rate of cardiovascular events is high.
We present a case of an 84-year-old female patient. She had bowel obstruction caused by a sigmoid colon tumor, severe mitral valve regurgitation, heart failure grade III, atrial fibrillation, hypertension, diabetes type II, chronic kidney failure grade II. At the time of admission, she had severe periumbilical pain, bowel obstruction by a sigmoid colon tumor and liver metastasis images on the computer tomography of the abdomen, atrial fibrillation, ventricular rate of 95 beats per minute on the electrocardiogram, mild mitral valve stenosis, severe mitral valve regurgitation, ejection fraction (EF) 58% on the heart ultrasound. She was made colostomy under general anesthesia and was cared for at the surgical resuscitation department after the surgery. She was discharged 10 days after the surgery.

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References

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