Journal of Anaesthesia & Critical Care Case Reports

Vol 4 | Issue 2 | May-Aug 2018 | page: 18-20 | Meenakshi Kumar, Mamta Pawar, Swarnendu Dey.

Authors: Meenakshi Kumar [1], Mamta Panwar [1], Swarnendu Dey [1].

[1] Department of Anaesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

Address of Correspondence

Dr. Meenakshi Kumar,
Consultant Anaesthesia,
A-224, Sector 31, Noida, Uttar Pradesh – 201 301, India.
E-mail: drmeenakshi86@yahoo.com

Abstract

Introduction: The incidence of patients posted for coronary artery bypass graft (CABG) with low ejection fraction (EF) is on the rise. These patients present a challenge for the attending anesthesiologist in the perioperative period as they have a poor tolerance to the stress of anesthesia as well as surgery. Maintaining forward flow with avoidance of arrhythmias and hypotension is the primary goals of balanced anesthesia.

Case Report: We describe successful anesthetic management in two adult male patients with Very low EF undergoing CABG. Conclusion: Both patients were successfully managed with pre-operative dobutamine infusion which improved the EF and intraoperative use of intra-aortic balloon pump which led to stable hemodynamics.

Keywords: Coronary artery bypass graft, low ejection fraction, dobutamine, intra-aortic balloon pump

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