A case report on the use of combined spinal epidural technique in the anaesthetic care of a patient with a large ASD and severe pulmonary hypertension

A defect in the septum between the left and right atrium is known as atrial septal defect which is a congenital heart disease. The defect causes shunting of blood from left to right side of the heart, increasing the blood flow through the lungs. Small atrial septal defects may be found incidentally and never cause a major concern. Larger defects may damage the heart and also the lungs. The use of combined spinal and epidural technique in a patient with ASD can maintain hemodynamic stability, provide perioperative analgesia and also avoid the hemodynamic perturbations associated with general anaesthesia in a patient with severe pulmonary hypertension.