Epidural Anesthesia in Patient with Idiopathic Hypertrophic Subaortic Stenosis / 대한마취과학회지

ABSTRACT

Idiopathic hypertrophic subaortic stenosis (IHSS) is characterized by asymmetric septal hypertrophy, wherein the upper portion of interventricular septum, and dynamic left ventricular outflow tract obstruction due to narrowing the subaortic area usually resulting from the middiastolic apposition of the mitral anterior leaflet against the hypertrophied septum. The goals of anesthetic management for IHSS are to prevent the development of dynamic obstruction to left ventricular ejection and to optimize ventricular filling by maintaining the heart in normal sinus rhythm. Spinal and epidural anesthesia decrease in the preload and afterload secondary to peripheral venous pooling and sympathetic blockade could act to increase the left ventricular outlet obstruction. We experienced the case of the epidural anesthesia for the dilatation and curettage of the uterus with IHSS, and there is no adverse effects of epidural anesthesia.