Anesthesia management in patient with nonobstructive hypertrophic cardiomyopathy with severe mitral valvular regurgitation with severe pulmonary artery hypertension for mitral valve replacement

Abstract

Hypertrophic cardiomyopathy (HCM) is a genetic disorder that is characterized by left ventricular hypertrophy unexplained by secondary causes and a nondilated left ventricle with preserved or increased ejection fraction. Mitral regurgitation is common in HCM secondary to distortion of mitral valve apparatus leading to systolic anterior motion. We report a case of HCM with rheumatic involvement of mitral valve with severe pulmonary artery hypertension and atrial fibrillation. With regard to hemodynamic management in patients with postcardiac surgery status, anesthetic management seems to be a “walk a tight rope.”