Perioperative management of post covid mucormycosis patient with dilated cardiomyopathy and atrial fibrillation posted for endoscopic debridement- A case report

Abstract

Anaesthesiologists being the frontline worker in COVID 19 pandemic, also contributed to the management of post-COVID sequelae like mucormycosis. Hereby reporting a case of successful anaesthetic management of a 60-year-old male with post COVID mucormycosis having an orbital extension, with co-morbidities like IHD, dilated cardiomyopathy, rate-controlled atrial fibrillation on regular treatment posted for emergency endoscopic debridement. Patient received amphotericin lipid complex. Preoperative 2D ECHO suggestive of ejection fraction of 23%, dilated LV, severe LV systolic dysfunction, mild MR, TR, AR, non-valvular atrial fibrillation, and no LA clot. While shifting the patient postoperatively, patient had a cardiorespiratory arrest, revived after 2 cycles of CPR and had atrial fibrillation with fast ventricular rate which was successfully cardioverted to normal sinus rhythm after synchronized cardioversion. Such cases always pose a challenge to anaesthesiologists as post covid systemic complications superadded with cardiac co-morbidities increase the overall risk.