Ultrasound-Guided Regional Anesthesia in a Patient with Complex Congenital Heart Disease and Acquired Valvular Heart Disease: A Case Report

Congenital heart disease, along with multiple valvular heart diseases, is a rare and complex cardiac condition. In such cases, regional anesthesia may be a preferred option due to its minimal impact on hemodynamics and effective postoperative analgesia. We successfully managed a case of combined congenital heart disease (atrial septal defect) and multiple valvular heart diseases (severe mitral and tricuspid regurgitation) with fracture humerus posted for k-wire insertion under ultrasound-guided interscalene brachial plexus block and superficial cervical plexus block. Ultrasound offers several advantages like identification of nerves, direct observation of local anesthetics (LA) deposition, faster onset, and longer duration of block with decreased dose of LA. USG-guided regional anesthesia proved to be a superior alternative to general anesthesia for the patient with complex congenital and valvular heart disease. It facilitated the surgical procedure with minimal hemodynamic fluctuations and effective postoperative analgesia.