successful anesthetic management for redo mitral valve replacement in the setting of severe postoperative right ventricular failure: a case report

Mitral regurgitation, a prevalent form of heart valve dysfunction, presents a significant challenge in global cardiovascular health. with diverse etiologies, this condition increasingly affects adult populations. over the past decades, the demand for redo valvular surgeries has steadily risen. the complexity of such procedures is further compounded when patients have underlying conditions such as severe ventricular failure, chronic hypertension, anemia, or drug allergies. right ventricular failure occurs when the right ventricle cannot maintain adequate blood flow through the pulmonary circulation to ensure proper filling of the left ventricle. this report highlights a remarkable case of mitral valve replacement (mvr) in a 46-year-old female with an extensive surgical history, including previous mitral valve repair and atrioventricular septal defect (avsd) repair. the patient also had chronic hypertension, anemia, and a documented allergy to valsartan. during surgery, she experienced acute right ventricular failure, necessitating complex medical management. this case underscores the critical need for thorough preoperative evaluation and meticulous intraoperative medical management in patients with intricate medical histories.