Abstract

Nowadays, children with hypoplastic left heart syndrome (HLHS) survive longer. Thus, the management of such patients undergoing non-cardiac surgery is of increasing relevance. A 12-month-old boy with HLHS following stage II Norwood palliation and Apert syndrome required extended craniosynostosis surgery because of elevated intracerebral pressure. Since extensive blood loss as well as hemodynamic instability were expected, anesthetic and surgical management were carefully planned in a multidisciplinary approach. Advanced invasive hemodynamic monitoring, well-balanced fluid and coagualtion management and an adapted ventilation strategy allowed this complex surgical procedure to be performed safely. Our case illustrates that complex non-cardiac surgery procedures with large volume shifts require a well-thought strategy in children with univentricular repair of congenital heart defects.

Authors and Affiliations