Filiz Ata, Tuğba Onur, Ahmet Burak Tatlı, Arda Aybars Pala, Ümran Karaca, Ayşe Neslihan Balkaya, Mesut Öztürk, Nuri Burkay Soylu, Pelin Köseoğlu, Harun Karaoğlu
Cardiac surgery in patients with suspected malignant hyperthermia (MH) susceptibility poses a distinct diagnostic and management challenge, as cardiopulmonary bypass (CPB)-induced hypothermia may mask early manifestations of MH. Given the rarity of this clinical scenario, we present our institutional perioperative protocol-encompassing preoperative workstation decontamination, trigger-free total intravenous anesthesia, CPB-specific precautions, and serial creatine kinase surveillance-illustrated through its successful application in a 47-year-old male undergoing elective four-vessel coronary artery bypass grafting. No clinical or biochemical evidence of MH occurred. We outline this structured approach as a practical reference for the cardiac surgical community.