Pacing and Pressure - Anesthesia For HOCM and Dual Devices in Transsphenoidal Surgery

Authors

Nitin Venkatesh, Oakland University William Beaumont School of Medicine Medical Student
Rania Fardous, Corewell Health East Resident
Roy Soto, Corewell Health East
Rohan Thakur

Document Type

Conference Proceeding

Publication Date

10-12-2025

Abstract

Hypertrophic obstructive cardiomyopathy (HOCM) poses unique perioperative risks due to dynamic LVOT obstruction and arrhythmogenic potential. We present the anesthetic management of a 76-year-old female with severe HOCM, dual-chamber AICD, and multiple cardiac comorbidities undergoing transsphenoidal resection of a pituitary macroadenoma. Key strategies included pre-induction arterial line placement, AICD deactivation with external defibrillator backup, and hemodynamic optimization to maintain sinus rhythm, preload, and afterload. Careful agent selection, volume management, and multidisciplinary coordination were critical. This case underscores the complexity of safely navigating high-risk cardiac physiology and device management in neurosurgical patients.

Comments

American Society of Anesthesiologists, The Anesthesiology Annual Meeting, October 10-14, 2025, San Antonio, TX

Recommended Citation

Venkatesh N, Fardous R, Soto R, Thakur R. Pacing and pressure - anesthesia for HOCM and dual devices in transsphenoidal surgery. Presented at: American Society of Anesthesiologists, The Anesthesiology Annual Meeting; 2025 Oct 12; San Antonio, TX. Available from:https://www.abstractsonline.com/pp8/#!/21028/presentation/9137