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Anesthetic considerations in a child with unrepaired D-transposition of great arteries undergoing noncardiac surgery.
Anesth Essays Res 2015 Sep-Dec; 9(3):440-2AE

Abstract

D-transposition of great arteries (D-TGA) is the most common cyanotic congenital heart disease diagnosed at birth. There is ventriculoarterial discordance leading to parallel circulation. The postnatal survival depends on intercirculatory mixing of oxygenated and deoxygenated blood at various levels through atrial septal defect, ventricular septal defect or patent ductus arteriosus. The anesthesiologist must have an understanding of concepts of shunting and other long-term consequences of transposition of great arteries (TGA) in order to tailor the anesthetic technique to optimize the hemodynamic variables and oxygenation in the perioperative period. The preoperative evaluation includes echocardiography to delineate the type of TGA, associated lesions and extent and direction of shunts. Oxygen saturation is influenced by the ratio of pulmonary vascular resistance (PVR) to systemic vascular resistance. Thus, care should be taken to avoid an increase in PVR which can lead to decreased pulmonary blood flow leading to hypoxia. We report a case of an 8-year-old child with unrepaired D-TGA, who presented to us for craniotomy for drainage of brain abscess.

Authors+Show Affiliations

Department of Anaesthesiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India.Department of Anaesthesiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India.Department of Anaesthesiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India.Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India.Department of Anaesthesiology, Mittal Hospital and Research Centre, Ajmer, Rajasthan, India.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

26712994

Citation

Mathur, Pooja, et al. "Anesthetic Considerations in a Child With Unrepaired D-transposition of Great Arteries Undergoing Noncardiac Surgery." Anesthesia, Essays and Researches, vol. 9, no. 3, 2015, pp. 440-2.
Mathur P, Khare A, Jain N, et al. Anesthetic considerations in a child with unrepaired D-transposition of great arteries undergoing noncardiac surgery. Anesth Essays Res. 2015;9(3):440-2.
Mathur, P., Khare, A., Jain, N., Verma, P., & Mathur, V. (2015). Anesthetic considerations in a child with unrepaired D-transposition of great arteries undergoing noncardiac surgery. Anesthesia, Essays and Researches, 9(3), pp. 440-2. doi:10.4103/0259-1162.158511.
Mathur P, et al. Anesthetic Considerations in a Child With Unrepaired D-transposition of Great Arteries Undergoing Noncardiac Surgery. Anesth Essays Res. 2015;9(3):440-2. PubMed PMID: 26712994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anesthetic considerations in a child with unrepaired D-transposition of great arteries undergoing noncardiac surgery. AU - Mathur,Pooja, AU - Khare,Arvind, AU - Jain,Neena, AU - Verma,Priya, AU - Mathur,Vivek, PY - 2015/12/30/entrez PY - 2015/12/30/pubmed PY - 2015/12/30/medline KW - Anesthesia KW - D-transposition of great arteries KW - cyanotic congenital heart disease KW - noncardiac surgery SP - 440 EP - 2 JF - Anesthesia, essays and researches JO - Anesth Essays Res VL - 9 IS - 3 N2 - D-transposition of great arteries (D-TGA) is the most common cyanotic congenital heart disease diagnosed at birth. There is ventriculoarterial discordance leading to parallel circulation. The postnatal survival depends on intercirculatory mixing of oxygenated and deoxygenated blood at various levels through atrial septal defect, ventricular septal defect or patent ductus arteriosus. The anesthesiologist must have an understanding of concepts of shunting and other long-term consequences of transposition of great arteries (TGA) in order to tailor the anesthetic technique to optimize the hemodynamic variables and oxygenation in the perioperative period. The preoperative evaluation includes echocardiography to delineate the type of TGA, associated lesions and extent and direction of shunts. Oxygen saturation is influenced by the ratio of pulmonary vascular resistance (PVR) to systemic vascular resistance. Thus, care should be taken to avoid an increase in PVR which can lead to decreased pulmonary blood flow leading to hypoxia. We report a case of an 8-year-old child with unrepaired D-TGA, who presented to us for craniotomy for drainage of brain abscess. SN - 0259-1162 UR - https://www.unboundmedicine.com/medline/citation/26712994/Anesthetic_considerations_in_a_child_with_unrepaired_D_transposition_of_great_arteries_undergoing_noncardiac_surgery_ L2 - http://www.aeronline.org/article.asp?issn=0259-1162;year=2015;volume=9;issue=3;spage=440;epage=442;aulast=Mathur DB - PRIME DP - Unbound Medicine ER -