Anesthetic Management at İmplantation of Permanent Pacemaker for Newborn with Congenital Complete Heart Block

Öz

Complete atrioventricular heart block is defined as non-conduction of electrical impulses from atria to ventricles. Atrial pace, independent from ventricles, is higher. Complete atrioventricular heart block begins at intrauterin life in newborns and it is called congenital complete heart block. Heart rate is the most important factor determining cardiac output among children and especially newborns. Newborns with congenital complete heart block have lower heart rate (<60 beat/min) and carry heart failure risk. Heart block is usually irreversible and affected newborns require permanent cardiac pacemaker from first week of their life. Understanding cardiovascular pathophysiology and knowing therapeutic approaches to congenital complete heart block are very important during perioperative management of these patients. In this case report we discussed general anesthetic management during implantation of permanent pacemaker for a newborn with congenital complete heart block. Key words: Anesthesia; Heart block; Newborn.

Anahtar Kelimeler

• Anesthesia; Heart block; Newborn.

Konjenital Komplet Kalp Bloğu Olan Yenidoğanda Acil Kalp Pili Takılması Sırasında Anestezik Yönetim

Öz

Komplet atriyoventriküler kalp bloğu atriyal elektriksel uyarının ventriküllere iletilememesi olarak tanımlanır. Atriyal kalp hızı ventrikülden bağımsız olarak daha fazladır. Yenidoğanlarda komplet atriyoventriküler kalp bloğu intrauterin dönemde başladığı için konjenital komplet kalp bloğu olarak adlandırılır. Kalp hızı özellikle yenidoğanda olmak üzere çocuklukta kardiyak outputu belirleyen en önemli etkendir. Komplet konjenital kalp bloğu olan çocuklar ise düşük kalp atım hızına (<60 atım/dk) sahiptir ve kalp yetmezliği riski vardır. Kalp bloğu sıklıkla geri dönüşümsüzdür ve etkilenmiş çocuklar yaşamlarının ilk haftasında uzun süreli kalıcı kalp piline gereksinim duyarlar. Kardiyovasküler patofizyolojiyi anlamak ve konjenital komplet kalp bloklu yenidoğanların tedavi şekilleri bu çocukların perioperatif bakımı için gereklidir. Bu olgu sunumunda konjenital komplet kalp bloğu olan bir yenidoğanda kalıcı kalp pili takılması sırasında genel anestezik yönetim tartışılmıştır. Anahtar kelimeler: Anestezi; Kalp bloğu; Yenidoğan.

Anahtar Kelimeler

• Anestezi; Kalp bloğu; Yenidoğan.

Kaynakça

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