CME Journal of Clinical Case Reports

Anesthesiologic Approach on Non-Cardiac Procedure on A Patient with Severe Aortic Stenosis

Abstract

Aleksandar Kishman and Simona Nikolovska

Administering anesthesia to patients with preexist-ing cardiac disease is an interesting challenge. Most com-mon cause of perioperative morbidity and mortality in cardiac patients is ischaemic heart disease (IHD). IHD is number one cause of morbidity and mortality all over the world. 73-year-old, male patient, was admitted to the Clinic of Plastic and Reconstructive surgery, with the following diagnosis: Carcinoma cutis exulcerans et sanguinans reg. praeauricularis l.dex. It was quite a challenge for this patient to be led in general anaesthesia, because of all of his conditions: Syndroma myelodisplasticus; St post transplantatio alogenes. HTA. Dementio vascularis. Paraplegia spastica, Coronary artery disease. Aortic stenosis. The condition is often unrecognized before death and post-mortem data suggest an end of life incidence of 1%. We decided to use Remifentanil over Fentanyl, since it has a unique pharmacokinetic profile, with a rapid onset and offset of action and a plasmatic metabolism. Because of the patient’s age, medical state, and the Remifentani’s effects, we highly recommend this type of anaesthesia.

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