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Pulmonary Hypertension Crisis in Patient with Tetralogy of Fallot and Mixed Total Anomalous Pulmonary Vein Connection after the Primary Correction:A Rare Case Report

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Congenital Heart Disease 2023年第6期18卷 671-678页

作者： Dian Kesumarini Yunita Widyastuti cindy elfira boom Lucia Kris Dinarti Department of Anesthesia and Intensive Therapy National Cardiovascular Center Harapan KitaJakartaIndonesia Doctoral Program Faculty of Medicine and Public HealthUniversity of Gadjah MadaYogyakartaIndonesia Department of Anesthesia and Intensive Therapy Universitas Gadjah Mada/Dr.Sardjito HospitalYogyakartaIndonesia Department of Cardiology and Vascular Medicine Universitas Gadjah Mada/Dr.Sardjito HospitalYogyakartaIndonesia

Tetralogy of Fallot(TOF)with total anomalous pulmonary vein connections(TAPVC)is a rare type of complex congenital heart disease among all TOF ***-presentation of major aortopulmonary collateral arteries(MAPCAs)compensates for the lack of central pulmonary bloodﬂow and decreases the severity of right-to-left shunting in *** present a case of a 2-year-old child with complex diagnoses of TOF,TAPVC,a large secun-dum atrial septal defect(ASD),and intraoperatively identiﬁed *** underwent surgery to repair the TAPVC,valve-sparing reconstruction of the right ventricular outﬂow tract,interventricular defect closure,and the creation of patent foramen ovale(PFO).After the operation,hemodynamic instability happened along with sudden blood pressure drop,desaturation,and increased central venous pressure,which subsided after adminis-tering inhalational nitric oxide(NO).A postoperative pulmonary hypertension crisis was suggested when the patient experienced recurrent symptoms after the termination of ***ﬁndings of a D-shaped left ventricle(LV),right-to-left PFO shunt and high tricuspid valve gradientﬁrmly established the *** was subsequently managed with continuous NO inhalation and sildenaﬁl,which rendered a satisfactory *** TOF and TAPVC could be at particular risk of developing pulmonary hypertension crisis,especially in the presence of MAPCAs due to possible remodeling of the pulmonary ***,a relatively non-compliant LV function and small left atrial size may exacerbate the risk of developing postcapillary pulmonary hypertension after TAPVC repair.A successful postoperative outcome calls for a meticulous preoperative analysis of the anatomical lesions,as well as careful monitoring.

关键词： Pulmonary hypertension crisis major aortopulmonary collateral arteries tetralogy of Fallot total anomalous pulmonary vein connection congenital heart disease case report

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Anesthetic Consideration on Neonatal Patient with Esophageal Atresia

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Open Journal of Anesthesiology 2016年第9期6卷 128-136页

作者： Reza Sudjud Tatang Bisri cindy elfira boom Department of Anesthesiology and Intensive Care Faculty of Medicine Padjadjaran University Bandung West Java Indonesia

Esophageal atresia is a disorder of the esophageal continuity with or without a connection with the trachea or the under-development esophagus. Most babies who suffer from esophageal atresia also have tracheoesophageal fistula (an abnormal connection between the esophagus and the trachea/windpipe). The possibility of these two conditions is accompanied by other anomalies such as congenital heart disease and anorectal malformations. Esophageal atresia can also be interpreted as malformations caused by the failure of the esophagus to develop a continual passage that may or may not establish a connection to the trachea (tracheoesophageal fistula) or it can be said that the esophageal atresia is the failure of the esophagus to form a channel from the pharynx to the stomach during embryonic development. Another understanding of esophageal atresia is an interruption in the growth of a segment of the esophagus and remains as thin sections without continual channels. Tracheal esophageal fistula is an abnormal connection between the trachea and esophagus. Miscellaneous types of esophageal atresia include: Type A. The incidence of Type A esophageal atresia was about 5% - 8%. Type A esophageal atresia occurs at each end of the esophageal sac, and is apart without fistula to the trachea. Type B incident is rare. Type B esophageal atresia occurs at each end of the esophagus, and there is fistula from the trachea to the upper segment of esophagus. Incidence of Type C esophageal atresia occurs about 80% - 95%. Type C esophageal atresia occurs at the proximal esophageal segment and ends at a dead-end sac, and distal segments are connected to the trachea or primary bronchus. Type D esophageal atresia is rare. In this type, upper and lower segment of the esophagus is connected to the trachea. Type E esophageal atresia is rare when compared with Types A and C esophageal atresia. In this type the esophagus and trachea are normal but they are connected with fistula.

关键词： Anesthesia Neonatal Esophageal Atresia

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