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Case Reports

Awake Heart Valve Surgery in a Patient With Severe Pulmonary Disease

Piotr Knapik, MD, PhD^_*, Roman Przybylski, MD, Pawe Nadziakiewicz, MD, Marian Zembala, MD, PhD

Silesian Center for Heart Diseases, Zabrze, Poland

Accepted for publication January 10, 2008.

^_* Address correspondence to Dr Knapik, Silesian Center for Heart Diseases, ul. Szpitalna 2, Zabrze, 41-800, Poland (Email: pknapik{at}slam.katowice.pl).

Cardiac operations may be performed in a conscious, spontaneously breathing patient, but it is difficult to justify an awake technique in patients undergoing coronary artery procedures with low operative risk. We describe an elderly patient with severe chronic obstructive pulmonary disease in whom general anesthesia was contraindicated. A valve procedure was performed under thoracic epidural anesthesia alone, thus avoiding intubation and mechanical ventilation. The patient had an uneventful postoperative course and excellent recovery.