A clinical case of anaesthetic management during reconstructive operations for obliterating atherosclerosis of the lower extremities with a low left ventricular ejection fraction

Abstract

Low ejection fraction is often a concomitant pathology in obliterating atherosclerosis of the lower extremities in the elderly seeking anesthetic care and a difficult task for the anaesthetist due to the increased risk of perioperative complications. The combined risk of low ejection fraction and poor cardiac reserve may lead to increased perioperative mortality during reconstructive surgery for obliterating atherosclerosis of the lower extremities. This article analyzes such a clinical case with a comparison of the tactics of anaesthetic management with world practice. Analysis of the clinical case shows that neuraxial methods and nerve block anesthesia provide better results in patients with cardiovascular diseases who have undergone non-cardiological surgery compared to general anesthesia.

Keywords

• obliterating atherosclerosis of the lower extremities
• neuraxial blockade
• left ventricular ejection fraction
• axillary-femo­ral bypass surgery