Indian Journal of Anaesthesia  
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CASE REPORT
Year : 2011  |  Volume : 55  |  Issue : 2  |  Page : 187-189

Anaesthetic management of a patient with Eisenmenger syndrome and β-thalassemia major for splenectomy


Department of Anesthesiology and Intensive Care, PGIMER and Associated Dr. RML Hospital, New Delhi, India

Correspondence Address:
Sarbjot Kaur
Department of Anesthesiology and Intensive Care, Room No. 127, Doctors Hostel, Dr. Ram Manohar Lohia Hospital, New Delhi - 01
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.79892

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We describe for the first time, the perioperative care of a patient with a rare combination of Eisenmenger syndrome with β-thalassemia major presenting for splenectomy. Patients with Eisenmenger syndrome have polycythemia because of chronic hypoxia but our patient was anaemic and had thrombocytopenia because of thalassemia major. The management of such a case can be challenging for any anaesthesiologist because of severe V/Q mismatch (high shunt fraction and restrictive lung disease because of hypersplenism), decreased oxygen carrying capacity (anaemia) and increased risk of haemorrhage (thrombocytopenia), along with the potential increase in intracardiac shunt during anaesthesia.


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