A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach

Dai-liang Zhao; Yan Li

doi:doi:10.11648/j.ijacm.20241202.13

Case Report |

| Peer-Reviewed

A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach

Dai-liang Zhao^*

, Yan Li

Published in International Journal of Anesthesia and Clinical Medicine (Volume 12, Issue 2)

Received: 6 May 2024 Accepted: 9 July 2024 Published: 31 July 2024

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

This case report presents a multi-disciplinary treatment (MDT) approach to optimize anesthetic management for an elderly patient with a giant inguinal hernia and severe left ventricular dysfunction. The patient, a 68-year-old male, had a 30-year history of a large inguinal hernia and was diagnosed with left ventricular hypertrophy and cardiac insufficiency, with an ejection fraction of 24%. Given the patient's complex comorbidities and the risks associated with anesthesia, a MDT was formed to develop a personalized treatment plan. The team included gastrointestinal surgeons, anesthesiologists, cardiovascular specialists, and intensive care physicians who collaborated to mitigate perioperative risks. The MDT strategy involved continuing preoperative cardiovascular medications, selecting anesthesia techniques to minimize impact, and maintaining strict fluid management during surgery. The patient underwent a successful tension-free repair of the inguinal hernia with the aid of an ultrasound-guided nerve block and local infiltration anesthesia. Throughout the procedure, vital signs remained stable, and the patient experienced no discomfort or complications related to anesthesia. The patient recovered well and was discharged after five days. The effectiveness of MDT in overseeing the care of elderly patients with high-risk conditions throughout the perioperative anesthesia phase is underscored. It underscores the importance of a collaborative approach to ensure patient safety and optimal outcomes in complex surgical cases. The MDT framework helps to prevent treatment deviations and delays, reducing patient anxiety and improving the overall quality of care.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 12, Issue 2)
DOI	10.11648/j.ijacm.20241202.13
Page(s)	81-84
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Multi-Disciplinary Treatment (MDT), Perioperative Anesthesia, High-Risk Elderly Patient, Patient Safety, Complication-Free Recovery

References

[1]	Vacas S, Canales C, Deiner SG, Cole DJ. Perioperative Brain Health in the Older Adult: A Patient Safety Imperative. Anesth Analg. 2022; 135(2): 316-328. https://doi.org/10.1213/ANE.0000000000006090
[2]	Makary MA, Segev DL, Pronovost PJ, et al. Frailty as a predictor of surgical outcomes in older patients [J]. Journal of the American College of Surgeons, 2010(6): 210. https://doi.org/10.1016/j.jamcollsurg.2010.01.028
[3]	Jablonski S G, Urman R D. The Growing Challenge of the Older Surgical Population [J]. Anesthesiology Clinics, 2019, 37(3). https://doi.org/0.1016/j.anclin.2019.04.001
[4]	Eamer G, Al-Amoodi M J H, Holroyd-Leduc J, et al. Review of risk assessment tools to predict morbidity and mortality in elderly surgical patients [J]. The American Journal of Surgery, 2018, 216(3): 585-594. https://doi.org/10.1016/j.amjsurg.2018.04.006
[5]	Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients [J]. Journal of the American College of Surgeons, 2006, 203(6): 865-877. https://doi.org/10.1016/j.jamcollsurg.2006.08.026
[6]	Chang T T, Sawhney R, Monto A, et al. Implementation of a multidisciplinary treatment team for hepatocellular cancer at a Veterans Affairs Medical Center improves survival [J]. Hpb, 2008, 10(6): 405-411. https://doi.org/10.1080/13651820802356572
[7]	Hansen MFC, Storkholm JH, Hansen CP. The results of pancreatic operations after the implementation of multidisciplinary team conference (MDT): A quality improvement study [J]. International Journal of Surgery, 2020, 77: 105-110. https://doi.org/10.1016/j.ijsu.2020.03.045
[8]	Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart disease and stroke statistics—2010 update: a report from the American Heart Association [J]. Circulation, 2010, 121(7): e46-e215. https://doi.org/10.1161/CIRCULATIONAHA.109.192667
[9]	Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association [J]. Circulation, 2011, 123(8): 933-944. https://doi.org/10.1161/CIR.0b013e31820a55f5
[10]	Barnett K, Mercer SW, Norbury M, et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study [J]. The Lancet, 2012, 380(9836): 37-43. https://doi.org/10.1016/S0140-6736(12)60240-2
[11]	Biccard BM, Rodseth RN. Utility of clinical risk predictors for preoperative cardiovascular risk prediction [J]. British Journal of Anaesthesia, 2011, 107(5): 446-450. https://doi.org/10.1093/bja/aer194
[12]	Patkar V, Acosta D, Davidson T, et al. Cancer Multidisciplinary Team Meetings: Evidence, Challenges, and the Role of Clinical Decision Support Technology [J]. International Journal of Breast Cancer, 2011, 2011: 831605. https://doi.org/10.4061/2011/831605
[13]	Holt N F. Trends in healthcare and the role of the anesthesiologist in the perioperative surgical home - the US perspective. [J]. Current Opinion in Anaesthesiology, 2014, 27(3): 371. https://doi.org/10.1097/ACO.0000000000000064
[14]	Brindley P G. I. Improving teamwork in anaesthesia and critical care: many lessons still to learn [J]. British Journal of Anaesthesia, 2014(3): 399-401. https://doi.org/10.1093/bja/aet334
[15]	Howell S J. Abdominal aortic aneurysm repair in the United Kingdom: an exemplar for the role of anaesthetists in perioperative medicine [J]. Br J Anaesth, 2017(suppl_1): i15–i22. https://doi.org/10.1093/bja/aex360
[16]	Taberna M, Gil Moncayo F, Jané-Salas E, et al. The multidisciplinary team (MDT) approach and quality of care [J]. Frontiers in oncology, 2020, 10: 85. https://doi.org/10.3389/fonc.2020.00085

Cite This Article

Plain Text BibTeX RIS

APA Style

Zhao, D., Li, Y. (2024). A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach. International Journal of Anesthesia and Clinical Medicine, 12(2), 81-84. https://doi.org/10.11648/j.ijacm.20241202.13

Copy | Download

ACS Style

Zhao, D.; Li, Y. A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach. Int. J. Anesth. Clin. Med. 2024, 12(2), 81-84. doi: 10.11648/j.ijacm.20241202.13

Copy | Download

AMA Style

Zhao D, Li Y. A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach. Int J Anesth Clin Med. 2024;12(2):81-84. doi: 10.11648/j.ijacm.20241202.13

Copy | Download

@article{10.11648/j.ijacm.20241202.13,
  author = {Dai-liang Zhao and Yan Li},
  title = {A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach
},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {12},
  number = {2},
  pages = {81-84},
  doi = {10.11648/j.ijacm.20241202.13},
  url = {https://doi.org/10.11648/j.ijacm.20241202.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20241202.13},
  abstract = {This case report presents a multi-disciplinary treatment (MDT) approach to optimize anesthetic management for an elderly patient with a giant inguinal hernia and severe left ventricular dysfunction. The patient, a 68-year-old male, had a 30-year history of a large inguinal hernia and was diagnosed with left ventricular hypertrophy and cardiac insufficiency, with an ejection fraction of 24%. Given the patient's complex comorbidities and the risks associated with anesthesia, a MDT was formed to develop a personalized treatment plan. The team included gastrointestinal surgeons, anesthesiologists, cardiovascular specialists, and intensive care physicians who collaborated to mitigate perioperative risks. The MDT strategy involved continuing preoperative cardiovascular medications, selecting anesthesia techniques to minimize impact, and maintaining strict fluid management during surgery. The patient underwent a successful tension-free repair of the inguinal hernia with the aid of an ultrasound-guided nerve block and local infiltration anesthesia. Throughout the procedure, vital signs remained stable, and the patient experienced no discomfort or complications related to anesthesia. The patient recovered well and was discharged after five days. The effectiveness of MDT in overseeing the care of elderly patients with high-risk conditions throughout the perioperative anesthesia phase is underscored. It underscores the importance of a collaborative approach to ensure patient safety and optimal outcomes in complex surgical cases. The MDT framework helps to prevent treatment deviations and delays, reducing patient anxiety and improving the overall quality of care.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach

AU  - Dai-liang Zhao
AU  - Yan Li
Y1  - 2024/07/31
PY  - 2024
N1  - https://doi.org/10.11648/j.ijacm.20241202.13
DO  - 10.11648/j.ijacm.20241202.13
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 81
EP  - 84
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20241202.13
AB  - This case report presents a multi-disciplinary treatment (MDT) approach to optimize anesthetic management for an elderly patient with a giant inguinal hernia and severe left ventricular dysfunction. The patient, a 68-year-old male, had a 30-year history of a large inguinal hernia and was diagnosed with left ventricular hypertrophy and cardiac insufficiency, with an ejection fraction of 24%. Given the patient's complex comorbidities and the risks associated with anesthesia, a MDT was formed to develop a personalized treatment plan. The team included gastrointestinal surgeons, anesthesiologists, cardiovascular specialists, and intensive care physicians who collaborated to mitigate perioperative risks. The MDT strategy involved continuing preoperative cardiovascular medications, selecting anesthesia techniques to minimize impact, and maintaining strict fluid management during surgery. The patient underwent a successful tension-free repair of the inguinal hernia with the aid of an ultrasound-guided nerve block and local infiltration anesthesia. Throughout the procedure, vital signs remained stable, and the patient experienced no discomfort or complications related to anesthesia. The patient recovered well and was discharged after five days. The effectiveness of MDT in overseeing the care of elderly patients with high-risk conditions throughout the perioperative anesthesia phase is underscored. It underscores the importance of a collaborative approach to ensure patient safety and optimal outcomes in complex surgical cases. The MDT framework helps to prevent treatment deviations and delays, reducing patient anxiety and improving the overall quality of care.

VL  - 12
IS  - 2
ER  -

Copy | Download

Author Information

Dai-liang Zhao

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China

Contact Email

http://orcid.org/0009-0001-2692-0433
Yan Li

Department of Ophthalmology, Chengdu BOE Hospital, Chengdu, China

http://orcid.org/0009-0006-9476-8492

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Zhao, D., Li, Y. (2024). A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach. International Journal of Anesthesia and Clinical Medicine, 12(2), 81-84. https://doi.org/10.11648/j.ijacm.20241202.13

Copy | Download

ACS Style

Zhao, D.; Li, Y. A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach. Int. J. Anesth. Clin. Med. 2024, 12(2), 81-84. doi: 10.11648/j.ijacm.20241202.13

Copy | Download

AMA Style

Zhao D, Li Y. A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach. Int J Anesth Clin Med. 2024;12(2):81-84. doi: 10.11648/j.ijacm.20241202.13

Copy | Download

@article{10.11648/j.ijacm.20241202.13,
  author = {Dai-liang Zhao and Yan Li},
  title = {A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach
},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {12},
  number = {2},
  pages = {81-84},
  doi = {10.11648/j.ijacm.20241202.13},
  url = {https://doi.org/10.11648/j.ijacm.20241202.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20241202.13},
  abstract = {This case report presents a multi-disciplinary treatment (MDT) approach to optimize anesthetic management for an elderly patient with a giant inguinal hernia and severe left ventricular dysfunction. The patient, a 68-year-old male, had a 30-year history of a large inguinal hernia and was diagnosed with left ventricular hypertrophy and cardiac insufficiency, with an ejection fraction of 24%. Given the patient's complex comorbidities and the risks associated with anesthesia, a MDT was formed to develop a personalized treatment plan. The team included gastrointestinal surgeons, anesthesiologists, cardiovascular specialists, and intensive care physicians who collaborated to mitigate perioperative risks. The MDT strategy involved continuing preoperative cardiovascular medications, selecting anesthesia techniques to minimize impact, and maintaining strict fluid management during surgery. The patient underwent a successful tension-free repair of the inguinal hernia with the aid of an ultrasound-guided nerve block and local infiltration anesthesia. Throughout the procedure, vital signs remained stable, and the patient experienced no discomfort or complications related to anesthesia. The patient recovered well and was discharged after five days. The effectiveness of MDT in overseeing the care of elderly patients with high-risk conditions throughout the perioperative anesthesia phase is underscored. It underscores the importance of a collaborative approach to ensure patient safety and optimal outcomes in complex surgical cases. The MDT framework helps to prevent treatment deviations and delays, reducing patient anxiety and improving the overall quality of care.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach

AU  - Dai-liang Zhao
AU  - Yan Li
Y1  - 2024/07/31
PY  - 2024
N1  - https://doi.org/10.11648/j.ijacm.20241202.13
DO  - 10.11648/j.ijacm.20241202.13
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 81
EP  - 84
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20241202.13
AB  - This case report presents a multi-disciplinary treatment (MDT) approach to optimize anesthetic management for an elderly patient with a giant inguinal hernia and severe left ventricular dysfunction. The patient, a 68-year-old male, had a 30-year history of a large inguinal hernia and was diagnosed with left ventricular hypertrophy and cardiac insufficiency, with an ejection fraction of 24%. Given the patient's complex comorbidities and the risks associated with anesthesia, a MDT was formed to develop a personalized treatment plan. The team included gastrointestinal surgeons, anesthesiologists, cardiovascular specialists, and intensive care physicians who collaborated to mitigate perioperative risks. The MDT strategy involved continuing preoperative cardiovascular medications, selecting anesthesia techniques to minimize impact, and maintaining strict fluid management during surgery. The patient underwent a successful tension-free repair of the inguinal hernia with the aid of an ultrasound-guided nerve block and local infiltration anesthesia. Throughout the procedure, vital signs remained stable, and the patient experienced no discomfort or complications related to anesthesia. The patient recovered well and was discharged after five days. The effectiveness of MDT in overseeing the care of elderly patients with high-risk conditions throughout the perioperative anesthesia phase is underscored. It underscores the importance of a collaborative approach to ensure patient safety and optimal outcomes in complex surgical cases. The MDT framework helps to prevent treatment deviations and delays, reducing patient anxiety and improving the overall quality of care.

VL  - 12
IS  - 2
ER  -

Copy | Download