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Unexpected refractory intra-operative hypotension during non-cardiac surgery: Diagnosis and management guided by trans-oesophageal echocardiography
Journal article   Open access   Peer reviewed

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

Sundara Reddy and Kenichi Ueda
Indian journal of anaesthesia, Vol.58(1), pp.51-54
2014
DOI: 10.4103/0019-5049.126796
PMCID: PMC3968653
PMID: 24700900
url
https://doi.org/10.4103/0019-5049.126796View
Published (Version of record) Open Access

Abstract

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.
Anaesthesia hypotension intraoperative monitoring trans-oesophageal echocardiography Case Report

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