Anaesthetic Management during Transposition of Great Arteries (TGA) Correction: Points to be Focussed
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2017, Vol 19, Issue 8
Abstract
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.
Authors and Affiliations
Swati Gupta, Anjum Saiyed, Reema Meena, Neelam Dogra
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