Abstract
<jats:p>The aim of the work is to describe a clinical case of successful anesthetic management of right-sided hemicolectomy in a patient with ischemic cardiomyopathy, critically low ejection fraction (19 %) and transplantation status. Left ventricular ejection fraction is one of the key indicators characterizing the pumping function of the heart. Normal values range within 50–75 %, while a decrease in ejection fraction below 35 % is associated with an increased risk of life-threatening arrhythmias. The presence of structural and functional cardiac abnormalities is recognized as the most important risk factor in predicting perioperative morbidity and mortality. Therefore, in the perioperative period, it is necessary to identify and correct all factors that can provoke cardiac decompensation, even before anesthesia and surgical intervention. A decrease in ejection fraction in our patient was a consequence of an acute myocardial infarction, which caused a persistent violation of myocardial contractility. In such cases, the hemodynamic changes that accompany anesthesia and surgery are of crucial importance, and the task of an anesthesiologist is to understand the pathophysiological mechanisms of the disease in order to prevent complications, including postoperative infarction, severe arrhythmias, critical bradycardia, and pulmonary edema. This clinical case presents a patient with ischemic cardiomyopathy and critically low ejection fraction (19 %) who was a candidate for heart transplantation and had a comorbidity in the form of a tumor of the ascending colon. The patient was scheduled for a right-sided hemicolectomy, which had an extremely high anesthetic risk and required an individualized approach.</jats:p>