Pulmoner kapak yokluğu ve majör aortopulmoner kollaterallerin eşlik ettiği fallot tetralojisi olan pediyatrik hastada anestezi yönetimi

Yıl 2018, Cilt: 1 Sayı: 1, 7 - 9, 31.12.2018

Feride Karacaer

Öz

Giriş:En sık
görülen konjenital kalp hastalıklarından olan Fallot tetralojisi’nde, eşlik
eden pulmoner kapak yokluğu ve majör aortopulmoner kollaterallerin varlığı
nadiren görülmektedir. Eşlik eden bu anomaliler, Fallot tetralojisi’nin
intraoperatif anestezi yönetimini komplike bir hale getirmektedir.

Gereç ve Yöntemler:Bu
olgu sunumunda, Fallot tetralojisi, pulmoner kapak yokluğu ve majör
aortopulmoner kollateral varlığı nedeniyle kardiyak düzeltme operasyonu geçiren
eşlik ettiği 9 yaşındaki hastamızın anestezi yönetiminin sunulması
amaçlanmıştır.

Sonuç:

Tartışma:

Anahtar Kelimeler

Fallot tetralojisi, pulmoner kapak yokluğu, majör aortopulmoner kollateral varlığı

Kaynakça

• 1. Hoffman JI, KaplanS. The incidence of congenital heart disease. Jam Coll Cardiol. 2002;39:1890–900.
• 2. Kirshbom PM, KogonBE. Tetralogy of Fallot with absent pulmonary valve syndrome.Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann. 2004;7:65–71.
• 3. Gharde P, Aggarwal N, Sharma KP, et al. Absent Pulmonary Valve in a Case of Tetralogy of Fallot: An Incidental Discovery on Intraoperative Transesophageal Echocardiography. Anesth Analg. 2017;125:1149-52.
• 4. Lakier JB, Stanger P, Heymann MA, Hoffman JI, Rudolph AM. Tetralogy of Fallot with absent pulmonary valve. Natural history and hemodynamic considerations. Circulation. 1974;50:167–75.
• 5. Grosse-Wortmann L, Yoo SJ, van Arsdell G, et al. Preoperative total pulmonary blood flow predicts right ventricular pressure in patients early after complete repair of tetralogy of Fallot and pulmonary atresia with major aortopulmonary collateral arteries. J Thorac Cardiovasc Surg. 2013;146:1185-90.
• 6. Malhotra SP, Hanley FL. Surgical management of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: a protocol-based approach. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2009;145-51.
• 7. Liao PK, Edwards WD, Julsrud PR, et al. Pulmonary blood supply in patients with pulmonary atresia and ventricular septal defect. J Am Coll Cardiol. 1985;6: 1343-50.
• 8. Quinonez ZA, Downey L, Abbasi RK, et al. Anesthetic Management During Surgery for Tetralogy of Fallot With Pulmonary Atresia and Major Aortopulmonary Collateral Arteries. World J Pediatr Congenit Heart Surg. 2018;9:236-41.
• 9. Carrillo SA, Mainwaring RD, Patrick WL, et al. Surgical Repair of Pulmonary Atresia With Ventricular Septal Defect and Major Aortopulmonary Collaterals With Absent Intrapericardial Pulmonary Arteries. Ann Thorac Surg. 2015;100:606-14.
• 10. Hoffman TM, Wernovsky G, Atz AM, et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation. 2003;107:996-1002.
• 11. Vogt W, La¨er S. Treatment for paediatric low cardiac output syndrome: results from the European EuLoCOS-Paed survey. Arch Dis Child. 2011;96: 1180-6.