Indian Journal of Anaesthesia

CASE REPORT
Year
: 2014  |  Volume : 58  |  Issue : 1  |  Page : 51--54

Unexpected refractory intra-operative hypotension during non-cardiac surgery: Diagnosis and management guided by trans-oesophageal echocardiography


Sundara Reddy, Kenichi Ueda 
 Department of Anesthesia, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City 52242, Iowa, USA

Correspondence Address:
Sundara Reddy
6JCP, Department of Anesthesia, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City 52242, Iowa
USA

We present a case of severe refractory hypotension in a patient undergoing de-bulking liver resection for massive polycystic liver disease. Emergent trans-oesophageal echocardiography (TOE) revealed dynamic left ventricular outflow tract (LVOT) obstruction with systolic anterior motion (SAM) of the anterior mitral leaflet (AML). Notably, he had a structurally normal heart on pre-operative trans-thoracic echocardiography (TTE). Diagnosis of SAM by TOE, possible mechanisms and specific management of refractory hypotension in this context are discussed.


How to cite this article:
Reddy S, Ueda K. Unexpected refractory intra-operative hypotension during non-cardiac surgery: Diagnosis and management guided by trans-oesophageal echocardiography.Indian J Anaesth 2014;58:51-54


How to cite this URL:
Reddy S, Ueda K. Unexpected refractory intra-operative hypotension during non-cardiac surgery: Diagnosis and management guided by trans-oesophageal echocardiography. Indian J Anaesth [serial online] 2014 [cited 2020 Nov 30 ];58:51-54
Available from: https://www.ijaweb.org/article.asp?issn=0019-5049;year=2014;volume=58;issue=1;spage=51;epage=54;aulast=Reddy;type=0