Anaesthetic management of an adult patient with Hypertrophic Obstructive Cardiomyopathy and Chronic kidney disease for Minimally Invasive Video Assisted Thoracoscopic Surgery

It is not an uncommon situation to encounter a patient for anaesthesia with multiple co-morbidities. Here we report successful anaesthetic management of Hypertrophic Obstructive Cardiomyopathy, Stage IV Chronic Kidney Disease, Lung Infection, immunosuppressed, posted minimally invasive video assisted thoracoscopy requiring one lung ventilation. Intraoperative hemodynamic stability was maintained etomidate, fentanyl, cisatracurium, desflurane & dexmedetomidine accurate bispectral depth sedation and precise fluid guidance transoesophageal echocardiography. The entire conduct planned avoid the left ventricular outflow tract obstruction maintain steady-state balance. This case learning experience how close vigilance appropriate use monitoring knowledge about disease per se resulted in uneventful perioperative period.