Anesthetic Management During Stenting of Obstructed Total Anomalous Pulmonary Return in a Neonate With Single Ventricle Anatomy

Abstract

Total anomalous pulmonary venous return (TAPVR) is a relatively rare congenital cardiac abnormality accounting for 1.5-3% of cases of congenital heart disease (CHD). Despite advances in surgical technique, surgical repair of TAPVR continues to be associated with a significant incidence of perioperative mortality. Morbidity and mortality associated with surgical repair of TAPVR increase dramatically when there are other associated cardiac defects, particularly single ventricle anatomy. We present a neonate with obstructed TAPVR and an unbalanced atrioventricular canal defect with hypoplastic left ventricle who presented for an interventional cardiac catheterization procedure (stenting of an obstructed vertical vein). The anesthetic management of such patients is discussed and options for intraoperative care are presented.