Successful Anesthetic Management of Coronary Artery Bypass Graft Patients with Very Low Ejection Fraction: Two Case Reports

Introduction: The incidence of patients posted for coronary artery bypass graft (CABG) with low ejection fraction (EF) is on the rise. These patients present a challenge for the attending anesthesiologist in the perioperative period as they have a poor tolerance to the stress of anesthesia as well as surgery. Maintaining forward flow with avoidance of arrhythmias and hypotension is the primary goals of balanced anesthesia. Case Report: We describe successful anesthetic management in two adult male patients with Very low EF undergoing CABG. Conclusion: Both patients were successfully managed with pre-operative dobutamine infusion which improved the EF and intraoperative use of intra-aortic balloon pump which led to stable hemodynamics. Keywords: Coronary artery bypass graft, low ejection fraction, dobutamine, intra-aortic balloon pump