Resumen

LOPEZ PEREZ, Leslie Ilse. MANAGEMENT IN PATIENT WITH AORTIC STENOSIS AND OBESITY. CASE PRESENTATION AND LITERATURE REVIEW. Rev. Méd. La Paz [online]. 2025, vol.31, n.1, pp.65-69.  Epub 30-Jun-2025. ISSN 1726-8958.

This clinical case focuses on the anesthetic management of a patient with severe stenotic aortic valve disease, who also presents with secondary pathologies that influence the anesthetic procedure, such as obesity with a high probability of a difficult airway and changes in respiratory physiology. Therefore, the objective is to describe the anesthetic procedure in this complex scenario.

A detailed preanesthetic assessment was performed, focusing on several systems, because heart disease generates changes at the respiratory, renal, and hepatic levels, changes that can influence the pharmacokinetics and pharmacodynamics of anesthetics. The transanesthetic procedure is described below, including airway management, mechanical ventilation, type of monitoring, and administration of anesthetic and vasoactive drugs.

Surgical intervention in these patients requires the full concentration of the anesthesiologist, as the administration of anesthetics generates mild to severe cardiovascular-pulmonary variations. Invasive monitoring is essential during cardiac surgery, and the ability to interpret cardiopulmonary clinical data is essential. Managing difficult airways includes preparation with special devices for accessing them, as well as skills for theirplacement. The infusion of vasoactive drugs and knowledge of theirpharmacologyprevents adverse and/or catastrophic events. The physiology of mechanical ventilation and possible changes due to the underlyingpathology require knowledge of different ventilation modes and their programming based on the corrected weight.

Therefore, the anesthesiology specialist must have the knowledge, skills, and abilities necessary for the variety of surgical-anesthetic events.

Palabras clave : Aortic stenosis; obesity; anesthesia.

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