Dealing with Dual Challenges Posed by an Uncorrected Atrial Septal Defect with Poliomyelitis- Anaesthetic Considerations for a Non Cardiac Surgery

Atrial Septal Defect (ASD) is one of the most common congenital heart diseases. This is one such disease where patients largely remain asymptomatic throughout childhood and begin showing symptoms during adulthood. Here the authors present a case of a 44-year-old patient, with an uncorrected ASD and poliomyelitis, who presented with fracture femur. He was posted for Open Reduction Internal Fixation (ORIF) with plating of femur. The anaesthetic management was successfully done with general anaesthesia through endotracheal intubation along with fascia iliaca block. After the procedure and extubation, the patient was conscious, oriented, responded to commands, and had normal vital parameters. He was shifted to the Intensive Care Unit(ICU) for further observation and monitoring in view of his pre-existing co-morbid conditions. Postoperatively, cardiovascular surgeon advised a correction surgery for his ASD at a later date. The patient was discharged on Postoperative Day(POD) 12. Dealing with these two vastly different disease entities in the same patient certainly posed a unique aspect to this case considering the fact that there was no prior literature regarding the same.