Anesthesia for an elderly female with a rare congenital heart disease - A case report

The long term survival of patients with Eisenmenger syndrome will make challenge for anesthetics; the risk during anesthesia of Eisenmenger syndrome may be increased. Combination of anesthetic considerations of Eisenmenger syndrome and anesthetic management of elderly patients must be considered. We present a case of female patient 78 year old with long standing Eisenmenger syndrome. Her ECHO cardiography showed ejection fraction 57%, dextrocardia, large VSD 1.4 cm with right to left shunt with systolic pressure gradient 70 mmHg, moderate to severe TR, moderate MR, dilated and hypertrophied RV with preserved systolic function, hugely dilated right atrium, and severe pulmonary hypertension with pulmonary artery systolic pressure 125 mmHg. The patient had future neck femur, arthroplasty under hemi spinal anesthesia. After one month she presented to us with dislocated joint, and hemiarthroplasty under hemispinal anesthesia was done again. (C) 2016 Publishing services by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists.