Anaesthetic implications of grown-up congenital heart disease

Lovell, A.

doi:10.1093/bja/aeh172

Cited by 115 publications

(112 citation statements)

References 92 publications

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“…[4] Practice of outpatient anaesthesia is more rare in pregnant women with cardiac disease. [5] During the pregnancy the cardiovascular changes and the hemodynamic effects of the sympathetic blockage with the birth generates the basic point of view for the risks and benefits of the neuroaxial block.…”

Section: Discussionmentioning

confidence: 99%

The Application Of Epidural anesthesıa in Pregnant Woman With Uncorrected Tetralogy Of Fallot: A Case report

Solmaz¹

2015

Agri

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OCTOBER 2015215 ÖzetFallot tetralojisi en sık görülen siyanotik doğumsal kalp hastalığıdır. Bu hastalarda doğum sonrası meydana gelen ani hemodinamik değişiklikler ciddi, yaşamı tehdit eden multiorgan komplikasyonlarına yol açar. Bu yüzden anestezi seçimi zordur. Otuz üç haftalık düzeltilmemiş Fallot tetralojili gebe sezeryan operasyonuna alındı. Sorunsuz bir şekilde epidural anestezi uygulandı. Hastanın vital bulguları ve genel durumu stabil seyretti ve ameliyat sonrası yoğun bakımda dört gün takipten sonra kadın doğum servisine devredildi. Fallot tetralojili gebe hastada epidural anestezi uygulamasında bölünmüş ve artan dozlarda levobupivakain uygulamasının güvenli olduğu kanısındayız. Bununla birlikte, bizim bu verilerimiz klinik uygulama miktarının artırılması ile daha da güçleneceğini düşünüyoruz.Anahtar sözcükler: Sezeryan; Fallot tetralojisi; anestezi epidural. SummaryTetralogy of Fallot is the most common cyanotic congenital cardiac disease. The hemodynamic changes which are present immediately after abdominal delivery may be resulted with serious, life-threatening multiorgan complications. Therefore the choice of anesthesia is very difficult. We describe the case of pregnant, 33 weeks gestation, with uncorrected tetralogy of Fallot who underwent caesarian section. The epidural anesthesia was performed uneventfully. After having stabile vital signs and a good general condition patient was followed up at the intensive care unit for 4 days. She was transferred to the obstetric service. We think that application of epidural anaesthesia with fragmented and increasing doses of slow levobupivacain in pregnant women with tetralogy of Fallot is safe. Nonetheless, this data of ours will grow stronger with the increase of the clinical application amount.

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Section: Discussionmentioning

confidence: 99%

The Application Of Epidural anesthesıa in Pregnant Woman With Uncorrected Tetralogy Of Fallot: A Case report

Solmaz¹

2015

Agri

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“…According to the "Growing-Up CHD" study [13], CHDs is the most frequent inborn defect [13]. Meanwhile, according to "FDA Outlines Oversight of Mobile Medical Application," 500 million smartphones were using healthcare applications at the end of 2015 [14].…”

Section: Related Workmentioning

confidence: 99%

Congenital Heart Defect Monitoring System for Children using Internet of Things

Assiri¹,

AlShanbari²,

AlGamdi³

et al. 2017

IJCA

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People around the world often neglect health issues because of the difficulties in obtaining care (in terms of time, cost, and effort) as part of an effective healthcare plan. Healthcare is especially costly for congenital heart defect patients since they must regularly visit hospitals for check-ups. This paper presents a monitoring system for children diagnosed with congenital heart defects (CHDs) that enable remote monitoring and provides feedback to parents in order to detect potential risks earlier. This system adapted the Internet of Things (IoT) technology to read and to monitor children's vital signs and then transfer them to an iOS phone application. The application provides parents with their child's vital sign history. In addition, it classifies the child's case as normal or abnormal using a rule-based classifier. In a case of emergency, parents can call an emergency number. Therefore, this system can reduce the efforts of parents and children while also providing needed healthcare. Users were easily able to use the application to monitor their children. The only struggle was with the medical sensors. General TermsInternet of Things, Classification.

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“…[5][6][7][8] Vongpatanasin et al conducted a literature review on Eisenmenger syndrome in adults, which noted that non-cardiac surgery should be avoided where possible since the administration of general anaesthesia in these cases may be associated with a peri-operative mortality rate of up to 20 per cent. 8,9 Many of the agents used for induction and maintenance of general anaesthesia depress myocardial function and reduce systemic vascular resistance, with a resultant increase in the magnitude of the right to left shunting and cyanosis. [9][10][11] This situation may be difficult to reverse and can lead to cardiac arrest.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Many of the agents used for induction and maintenance of general anaesthesia depress myocardial function and reduce systemic vascular resistance, with a resultant increase in the magnitude of the right to left shunting and cyanosis. [9][10][11] This situation may be difficult to reverse and can lead to cardiac arrest. Similarly, outpatient conscious sedation carries the risk of increasing hypoxia that may be difficult to reverse.…”

Section: Introductionmentioning

confidence: 99%

The implications and management of acute odontogenic infection in association with Down and Eisenmenger syndromes and schizophrenia in a rural setting

Butler¹,

Cane

2007

Australian Dental Journal

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Background: This report describes the case management of a 32 year old special needs patient with life-threatening odontogenic infection. The combination of schizophrenia, Down and Eisenmenger syndromes presented significant challenges to managing his oral health, particularly within the rural context. In this case, dental treatment was limited to a full dental clearance during a high risk general anaesthesia session. Method: A comprehensive work-up prior to general anaesthesia was an essential aspect of care. This included a full medical history and examination, communication between medical specialists, the dentist and family consultation. The anaesthetic procedure was undertaken using a careful regimen of drugs and monitoring to minimize the impact on his cardiovascular system. Techniques to minimize bleeding from extraction sites were also important. Results: Three weeks postsurgically the patient was reviewed and his family reported that he was interacting positively with them after years of surliness and conflict. This was attributed to a managed psychotropic medication regimen and improved dental condition, which has led to a sustained improvement in quality of life. Conclusions: The management of acute odontogenic infection for special needs patients in the rural setting requires a local interdisciplinary team approach, careful consideration of related pathophysiology and its potential impact on general anaesthesia, and close consultation with family and carers.

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Anaesthetic implications of grown-up congenital heart disease

Cited by 115 publications

References 92 publications

The Application Of Epidural anesthesıa in Pregnant Woman With Uncorrected Tetralogy Of Fallot: A Case report

The Application Of Epidural anesthesıa in Pregnant Woman With Uncorrected Tetralogy Of Fallot: A Case report

Congenital Heart Defect Monitoring System for Children using Internet of Things

The implications and management of acute odontogenic infection in association with Down and Eisenmenger syndromes and schizophrenia in a rural setting

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