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

Sundara Reddy, Kenichi Ueda

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)51-54
Number of pages4
JournalIndian Journal of Anaesthesia
Volume58
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Keywords

  • Anaesthesia
  • Hypotension
  • Intraoperative monitoring
  • Trans-oesophageal echocardiography

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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