Left Ventricular outflow tract Obstruction poses unique challenges in the perioperative period due to its hemodynamic implications, especially in elderly patients who often present with multiple comorbidities and decreased cardiopulmonary reserve. Each case describes the preoperative optimization and perioperative management tailored to the individual patient\u27s condition. Despite varying degrees of Left ventricular Outflow Tract Obstruction and associated comorbidities, all patients underwent fractional spinal anesthesia. Fractional spinal anesthesia was shown to maintain hemodynamic stability and a longer duration of action
