Strategic Postoperative Management in High-Risk Cardiac Surgery: Navigating ECMO, Persistent Infection, and Pacemaker Dependency

This case report describes the intensive management of a 46-year-old female with a history of left ventricular outflow tract (LVOT) obstruction who underwent redo sternotomy, aortic root enlargement, and mechanical valve replacement. Despite multiple interventions including ECMO, the patient's course was complicated by persistent bacteremia, challenges in weaning from mechanical ventilation, and multi-organ dysfunction. This case highlights the complexities of managing high-risk cardiac surgery patients in the ICU setting, emphasizing the need for multidisciplinary approaches and vigilant postoperative care. Background: Patients with complex cardiac histories undergoing major surgeries like aortic valve replacement and LVOT obstruction management often face significant postoperative challenges. These include hemodynamic instability, infection risks, and the need for mechanical circulatory support, all of which necessitate a well-coordinated multidisciplinary approach. Objective: To discuss the management complexities and multidisciplinary care approach in a high-risk cardiac surgery patient with multiple postoperative complications.