Anesthesia management of a patient with heart transplant for non-cardiac surgery – case report and literature review
Iverka Brigljević Kniewald, Renata Curić Radivojević, Višnja Ivančan
Since the first human cardiac transplantation in 1967, approximately 3,500 heart transplants are performed every year in the world and post-operation survival period average is 15 years. Due to these facts these patients are now presenting for various non-cardiac procedures. The information regarding the physiological and pharmacological interactions in a denervated allograft heart, the side-effects of immunosuppression, the risk of infection, and the potential for rejection is essential for anesthetic management. This case report reviews the anesthetic management of a heart transplant recipient undergoing a total thyroidectomy. She was NYHA I, ASA grade III with normal alograft function and sinus rhythm. Anesthesia was performed in general endotracheal anesthesia. Neuromuscular block was reversed with sugammadex and she was discharged after three days.