Anesthetic Management of a High-Risk Patient with Mechanical Valve Prostheses Undergoing Open Cholecystectomy: A Case Report

Abstract

Worldwide, about 13% of the 200,000 annual recipients of prosthetic heart valves present for various non-cardiac surgical procedures When such cases present, both the anesthesiologist and the surgeon have to deal with the perioperative management of anticoagulation and a host of other issues involved and the potential for hemodynamic compromise. We report the perioperative management of a 65-year-old female with mechanical aortic and mitral valve prostheses, reduced ejection fraction, and pulmonary hypertension requiring cholecystectomy. Comprehensive preoperative optimization, anticoagulation bridging, meticulous perioperative monitoring, and cardiac-stable anesthetic techniques ensured an uneventful intraoperative and postoperative course.