Anesthetic management of tracheoesophageal fistula repair in a newborn with hypoplastic left heart syndrome

Saade, Edouard; Setzer, Nancy

doi:10.1111/j.1460-9592.2005.01807.x

Cited by 11 publications

(8 citation statements)

References 6 publications

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“…However, some patients are required to have noncardiac surgeries even before cardiac intervention. Several case reports have described anesthetic management for these patients [22][23][24]. Noncardiac surgeries for this population occur mostly on emergent basis.…”

Section: Presurgical Repairmentioning

confidence: 96%

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

2011

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Patients with congenital heart diseases are a growing population, and noncardiac surgeries will become an important health care issue. Patients with single ventricle physiology are a particularly challenging population who will undergo staged, palliative repair toward a final step of Fontan circulation. Although Fontan surgery creates a serial circulation in which the ventricle pumps blood to the systemic circuit, pulmonary blood flow occurs without a dedicated ventricle. Despite progress in outcomes, this abnormal circulation remains associated with various co-morbidities such as ventricular dysfunction, arrhythmias, protein losing enteropathy, and plastic bronchitis. Health care professionals must prepare for these patients to present to noncardiac surgery at any stage of intervention, possibly with complications. Given that staged, palliative repair has undergone multiple modifications, patients who present for surgery can vary in types and timing of the repair. Anesthesiologists who care for them must be familiar with perioperative issues to optimize outcomes, especially because congenital heart disease is a risk factor for increased mortality for noncardiac surgery.

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Section: Presurgical Repairmentioning

confidence: 96%

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

2011

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“…Milrinone and adrenaline infusions are prepared for cardiac support. We have not used hypoxic gas mixtures (1). Higher inspired oxygen concentrations are used only if the SpO 2 persistently falls below 70%, and we aim for a PaCO 2 of 5.5 kPa (12).…”

Section: Discussionmentioning

confidence: 99%

“… Summary Centers with large cardiac workloads may be presented with neonates who need major general surgery before correction or palliation of a serious cardiac defect. This is still a rare situation with only three short case reports available in the medical literature (1–3). We have reviewed the anesthetic and analgesic regimens of 18 such neonates who presented to the Birmingham Children’s Hospital in the 4‐year period 2004–2007.…”

mentioning

confidence: 99%

Anesthesia for major general surgery in neonates with complex cardiac defects

Walker

Stokes

Moriarty

2009

Pediatric Anesthesia

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Centers with large cardiac workloads may be presented with neonates who need major general surgery before correction or palliation of a serious cardiac defect. This is still a rare situation with only three short case reports available in the medical literature (1-3). We have reviewed the anesthetic and analgesic regimens of 18 such neonates who presented to the Birmingham Children's Hospital in the 4-year period 2004-2007. These children require meticulous preoperative evaluation and although it might be anticipated that they would pose a serious challenge to anesthetists, in reality with thorough investigation, preparation, and careful management, they tolerate general anesthesia well. These children may be transferred to centers of specialist pediatric cardiac anesthesia to be benefited from experience obtained there.

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“…An even smaller number of patients with these associated abnormalities require surgical intervention prior to correction or palliation of the cardiac defect. Although multiple case reports and studies of major general surgery and CHD have been published, few involve patients with an unrepaired double-outlet right ventricle [2][3][4][5]. The anesthetic management of a neonate with a double-outlet right ventricle and associated tracheoesophageal fistula, who underwent repair of this fistula, is presented.…”

Section: Introductionmentioning

confidence: 96%

Anesthetic management of tracheoesophageal fistula repair in a newborn with a double-outlet right ventricle

McClung

Prasad

Schwartz

2011

Journal of Clinical Anesthesia

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Anesthetic management of tracheoesophageal fistula repair in a newborn with hypoplastic left heart syndrome

Abstract: We present a case of a newborn with hypoplastic left heart syndrome (HLHS) and tracheoesophageal fistula (TEF). The anesthesia management for the repair of the TEF is presented and the management of the unique pathophysiology of the HLHS circulation is discussed.

Cited by 11 publications

References 6 publications

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

Anesthetic management of noncardiac surgery for patients with single ventricle physiology

Anesthesia for major general surgery in neonates with complex cardiac defects

Anesthetic management of tracheoesophageal fistula repair in a newborn with a double-outlet right ventricle

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