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Anesthetic Management of an Elderly Frail Patient with Dilated Cardiomyopathy and Poor Ejection Fraction in Prone Position – Case Report

Year: 2026

Type: article

Abstract: Anesthetic management of elderly, frail patients with dilated cardiomyopathy (DCM) and severely reduced ejection fraction in the prone position is challenging due to high risks of perioperative cardiac events and difficulties in resuscitation. We present a case of a 70-year-old patient with multiple comorbidities diagnosed with L4–L5 infective spondylodiscitis and L5 vertebral collapse who successfully underwent lumbar laminectomy and decompression with instrumentation. Key elements contributing to successful management included comprehensive pre-anesthetic evaluation, optimization of cardiac and general health, detailed counseling regarding perioperative risks, thorough understanding of DCM pathophysiology, careful consideration of patient frailty, vigilant intraoperative hemodynamic monitoring, and effective postoperative analgesia. This case highlights essential strategies for managing high-risk patients with DCM in prone surgical positions.

Source: Journal of Neuroanaesthesiology and Critical Care

DOI: 10.1055/s-0046-1820414

Authors: Deep Sengupta, Lokesh Walvekar, Sai K. Savarapu, Subodh Raju

Institution: Asian Institute of Gastroenterology

Language: English

Topic: Cardiac, Anesthesia and Surgical Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7160611819