Cases drawn from the OR — the decisions, reasoning, and evidence that shaped them.
A 48-year-old woman with severe mitral stenosis and severe pulmonary hypertension undergoes PBMV — complicated by severe MR and pulmonary edema, requiring emergency MVR. An anaesthetic exploration of the right heart and pulmonary hypertensive crisis.
A 51-year-old woman with acute-on-chronic limb ischemia after a fem-fem bypass, undergoing emergency femoral-to-popliteal bypass. Intraoperative hypertensive crisis, cardiac arrest in the ICU, and a redo thrombectomy caught in time.
A 27-year-old woman with tubercular pyopneumothorax and lung entrapment underwent left decortication. Thoracic epidural, one-lung ventilation with a 32 Fr DLT, and protective lung strategy — why saturation held despite a chronically collapsed left lung.
A 15-year-old undergoing right VATS metastasectomy. Four-witness confirmation of double-lumen tube position — auscultation, bronchoscopy, chest excursion, and lung ultrasound.
A femoral vein that looked clear in transverse view. A 90° probe rotation that found a floating thrombus before the needle did.
Borderline cuff leak test, delayed-onset airway edema after prolonged steep Trendelenburg, and what a passing result doesn't promise.