Anesthetic management for laparoscopic cholecystectomy in a patient with severe mitral regurgitation and severely depressed cardiac function

Abstract

Severe mitral valve disease in an elderly patient, may exhibit serious hemodynamic disturbance and pose a great challenge to the anesthesiologist. During laparoscopy, positive pressure pneumoperitonium with carbon dioxide insufflation has additional deleterious effects on hemodynamic stability. This case report describes successful management of a patient with severe mitral regurgitation scheduled to undergo laparoscopic cholecystectomy. It highlights the importance of adequate optimization, perioperative monitoring and use of preemptive regional anesthesia.