Abstract
We describe the case of a 72-year-old male suffering from Marfan syndrome, who, because of cardiac abnormalities correlated to the syndrome, received an orthotopic heart transplant four years ago. In 2024, he was diagnosed with right colon cancer. The decision to operate was difficult because of the elevated perioperative risk. Focused on the possible cardiologic and respiratory complications, we decided to proceed with neuraxial anesthesia during spontaneous breathing. This emergent anesthesiological strategy for open and laparoscopic abdominal surgery has the potential to abolish many risks related to general anesthesia. Right laparoscopic hemicolectomy was successfully performed, and no medical or surgical complications occurred in the postoperative period.