Anaesthesia management for aneurysm clipping surgery in patients with severe aortic stenosis with regurgitation: A case report

Coexistence of both intracranial aneurysm and aortic stenosis is quiet rare but it may complicate management of either disease. Managing it is like tug of war, but a good case manager can find that delicate balance. We recently managed patient with severe aortic stenosis presented with anterior communicating aneurysmal.Case-52year old female with complaints of severe headache and vomiting episodes since 10 days. With known case of hypertension and hypothyroid since 4 years on irregular medications posted for aneurysmal clipping. On pre assessment check-up we found pansystolic murmur on auscultation. On investigations it revealed concentric LVH with severe AS with moderate AR maintaining 60% ejection fraction. Other routine investigation were normal. Case was successfully conducted under general anaesthesia with endotracheal tube intubation with pre induction arterial line insertion. Anaesthesia management was tailored keeping in mind hemodynamic stability throughout procedure. With all standard ASA monitoring.