24 year old man with deforming arthropathy and limitation of hip movement. He also has features of aortic stenosis and allergy to food in a way that he develop vomiting from certain foods with irritability, impairment in memory, forgetting, and nervousness.
Obviously one can not cure all the problems. Which symptom troubles your patient most and may be start with that first.
You can find recommendations for anesthetic management in patients with hurler syndrome at orphananesthesia.eu. Consider spinal catheter to avoid difficult airway management and rapid hemodynamic changes.
I advise you to do epidural (lumbar) which is better for cardiac patient undergoing non-cardiac surgery,plus the catheter for postoperative pain management.
Careful assessment of AS severity. Consultation at a center with experience in percutaneous approaches to management of aortic stenosis.
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