[Patient whose surgery was postponed due to complete atrioventricular block on arrival at operating theater].

Abstract

An 86-year-old woman with low cardiac function was scheduled to undergo hip fracture surgery. Preoperative electrocardiogram showed complete left bundle brunch block, first degree atrioventricular block, left axis deviation and bigeminy. However, her electrocardiogram had changed to complete atrioventricular block on arrival at operating theater. ACC/AHA guideline on perioperative cardiovascular evaluation and care for non cardiac surgery indicates the assessment of both the urgency of the surgery and cardiac complications. Because complete atrioventricular block is classified to "active cardiac conditions", we decided to postpone the surgery for more detailed evaluation and treatment of cardiac conditions. In spite of the discontinuation of digoxin and carvegilol, complete atrioventricular block continued for a week, and the permanent pacemaker was inserted. The surgery was performed 2 weeks following the insertion of the pacemaker without any problems under combined general and lumbar epidural anesthesia.

• Authors: Azusa Kato, Toshiya Koitabashi, Takao Kato, Hideharu Agata, Takashi Ouchi, Ryohei Serita
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 60 Issue 6 Pg. 706-9 (Jun 2011) ISSN: 0021-4892 [Print] Japan
• PMID: 21710768 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Aged, 80 and over
• Anesthesia, Epidural
• Anesthesia, General
• Atrioventricular Block (diagnosis, therapy)
• Electrocardiography
• Female
• Hip Fractures (surgery)
• Humans
• Operating Rooms
• Pacemaker, Artificial
• Practice Guidelines as Topic
• Preoperative Care
• Preoperative Period