Aortic Stenosis

AORTIC STENOSIS

A 65-year-old woman presents for aortic valve replacement. The patient had an episode of congestive heart failure, which led to a recent hospital admission.

A cardiac catheterization at that time showed a peak systolic gradient of 90 mmHg between the left ventricle and the aorta. During anesthetic induction with fentanyl and vecuronium, the patient develops a junctional rhythm and severe hypotension.