Video-assisted lung lobectomy in cardiac transplant recipient: Dynamic monitoring of cardiac output and fluid responsiveness

Introduction: Heart transplant recipients have a significantly higher risk of any “de novo” cancer due to immunosuppressive therapy and also they have an increasing risk of infections. Carcinoma of lung represents one of the five most common malignancies in these transplant populations. Patients’ comorbidities may request high invasive intraoperative monitoring, as well as neuraxial analgesia to avoid acute pain stress response, exposing patients to iatrogenic nosocomial infection. Case Report: Our patient was admitted to thoracic surgery ward for lung adenocarcinoma and video assisted lung lobectomy was planned. She received heart transplantation 15 years before due to idiopathic dilatative cardiomyopathy and she had chronic rejection six years after transplant treated with corticosteroid therapy. Conclusion: Anesthesia management can be difficult in cardiac transplant recipients due to a potentially impaired heart function and hypotension should be avoided due to preload dependence