British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 19, Issue.: 8
Anaesthetic Management during Transposition of Great Arteries (TGA) Correction: Points to be Focussed
Swati Gupta1*, Anjum Saiyed1, Reema Meena1 and Neelam Dogra1 1Department of Anesthesiology, SMS Medical College, Jaipur, India.
Swati Gupta1*, Anjum Saiyed1, Reema Meena1 and Neelam Dogra1
1Department of Anesthesiology, SMS Medical College, Jaipur, India.
(1) Murali P. Vettath, Department of Cardiovascular-Thoracic & Heart Transplantation, Director-International Center of Excellence in OPCAB Surgery, Malabar Institute of Medical Sciences, Govindapuram, Kozhikode, Kerala, India.
(2) Gareth J. Morgan, Department of Congenital Cardiology, Evelina London Children’s Hospital, Guys and St Thomas’ NHS Foundation Trust, Hon Senior Clinical Lecturer, Kings College, London, UK.
(3) Vijayalakshmi I. Balekundri, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India.
(4) Alexander D. Verin, Vascular Biology Center, Georgia Regents University Augusta, Georgia.
(5) Salomone Di Saverio, Emergency Surgery Unit, Department of General and Transplant Surgery, S. Orsola Malpighi University Hospital, Bologna, Italy.
(1) Lalit Gupta, Delhi University, India.
(2) B. H. Natesh, Sri Jayadeva Institute of Cardiology and Vascular Sciences, Jayanagar, Bengaluru, India.
Complete Peer review History: http://www.sciencedomain.org/review-history/17719
Transposition of great arteries (TGA) is combination of concordant atrioventricular and discordant ventriculo-arterial connections and is divided into dextro-looped (d-TGA) and levo-looped (l-TGA) based on whether the atria and ventricles are concordant or discordant, respectively. Arterial switch operation is the procedure of choice but other surgical surgical options exists. In our case, a 4 month old boy presented with cyanosis, delayed milestone, diagnosed d-TGA with ASD came for surgical repair. Arterial switch repair was planned but due to decreased right ventricular pressure and raised pulmonary arterial pressure, mustard-senning procedure was performed. Hypoxia, systemic hypoxemia, metabolic acidosis, hypercarbia, sympathetic nervous stimulation due to light plane of anaesthesia can trigger a rapid rise in PVR, and even a pulmonary hypertensive crisis. Our aim was to prevent alteration in SVR and PVR in order to prevent desaturation especially at time of induction and off CPB bypass.
TGA; atrial switch.
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DOI : 10.9734/BJMMR/2017/30290Review History Comments