Anesthetic managemet for kyphoscoliosis correction in a patient with a large asd with moderate pulmonary hypertenion: a case report

Introduction: Kyphoscoliosis is a complex deformity of the spine and anaesthesia for kyphscoliosis surgery associated with CHD can be challenging, with several aspects to be kept in mind simultaneously. Patients should be evaluated in terms of airway difficulties, respiratory, cardiovascular and neurological system disorders in the preoperative evaluation. Particular attention should be paid to important cardiac problems and congenital anomalies. Cardiac pathologies such as atrial septal defect (ASD) may be most common. Case Report: A 16year old male with k/c/o kyphoscoliosis with recently diagnosed ASD was posted for kyphoscoliosis correction surgery. On examination patient had complaints of dyspnea on exertion. Airway assessment revealed mallampati grades 1 with mouth opening of 3 fingers, neck movements were normal. Discussion: Kyphoscoliosis associated with ASD pose a great challenge to the anesthetist as both of them cause severe cardiopulmonary compromise. Kyphoscoliosis is a progressive spinal deformity characterized by anterior flexion and lateral curvature of vertebra. Patient with severe spinal deformity usually have smaller lung volume and loss of thoracic elasticity resulting in increased energy requirements. Conclusion: Kyphoscoliosis with ASD poses a great challenge for anesthetist as both may cause cardiopulmonary complications.