Perioperative Management of Patient with Coronary Artery Disease 3 Vessels Disease, Chronic Total Occlusion in Left Anterior Descending and Right Coronary Artery, History of Hypertension, Extensive Myocardial Infarction and Low Ejection Fraction: A Case Report

Introduction: Achieving a satisfactory hemodynamic performance is the primary objective in the management of cardiac surgery patient. Optimal cardiac function ensures adequate perfusion and oxygenation of other organ systems (in particular vital organs) and improves the chances for an uneventful recovery from surgery. Case: A 46 year old male diagnosed with Coronary Artery Disease 3 Vessel Disease (CAD 3 VD), CTO in LAD and RCA, history of hypertension, extensive myocard infarction with hypertrophy as well as global function impairment of the left ventricle and low ejection fraction, who underwent Coronary Artery Bypass Graft (CABG). Supportive medications, such as dobutamine and nitroglycerin (NTG) were initiated and maintained intraoperatively, especially after anesthetic induction due to hemodynamic alterations. Patient was able to wean from cardiopulmonary bypass (CPB) machine and transferred to the ICU postoperatively.