Hemodynamic Stability of Midazolam versus Remimazolam During Outpatient Genitourinary Interventional Radiology Procedures in a Patient With Aortic Stenosis: A Case Report

Patients with aortic stenosis (AS) and other significant cardiopulmonary comorbidities are vulnerable to hemodynamic instability during anesthesia. This case report compares the use of remimazolam and midazolam in a 71-year-old man with symptomatic AS, chronic kidney disease, and ischemic cardiomyopathy. The patient underwent multiple short ambulatory interventional radiology procedures. While moderate sedation with midazolam resulted in significant hypotension, use of remimazolam in subsequent procedures demonstrated a stable hemodynamic profile despite increased disease burden. This report highlights the potential advantages of remimazolam compared to midazolam in high-risk patients undergoing interventional radiology procedures.