Anesthesia management of laparoscopic right colectomy in an older patient with postoperative tetralogy of Fallot with residual anomaly

IF 0.8 Q3 ANESTHESIOLOGY JA Clinical Reports Pub Date : 2024-04-11 DOI:10.1186/s40981-024-00707-2

Satori Mori, Hisakatsu Ito, Sadamu Sugimoto, Daisuke Hibi, Akiyo Kameyama, Masaaki Kawakami, Tomonori Takazawa

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Abstract

Diversity in hemodynamics of adult congenital heart disease necessitates a case-by-case selection of appropriate surgical and anesthetic options. However, previous case reports regarding the management of laparoscopic surgery in adult patients with congenital heart disease are limited. A 72-year-old man who underwent a laparoscopic right colectomy for colon cancer had a residual ventricular septal defect and right ventricular outflow tract obstruction despite post-repair of tetralogy of Fallot. Pulmonary hypertension or right ventricular dysfunction was not observed. The preoperative pulmonary to systemic blood flow ratio (Qp/Qs) was 2.3. After positive pressure ventilation and insufflation, the amount of left-to-right ventricular shunting decreased, and the Qp/Qs approached 1.0, as calculated from pulmonary arterial and systemic arterial blood gas analysis. Laparoscopic surgery might be tolerable in patients with tetralogy of Fallot who have preserved the right ventricular function, left-to-right ventricular shunting, and no high pulmonary vascular resistance.

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法洛氏四联症术后残留畸形老年患者腹腔镜右结肠切除术的麻醉管理

成人先天性心脏病的血流动力学各不相同，因此需要根据具体情况选择合适的手术和麻醉方案。然而，以往关于先天性心脏病成人患者腹腔镜手术治疗的病例报告非常有限。一名 72 岁的男性因结肠癌接受了腹腔镜右结肠切除术，尽管他的法洛氏四联症已经修复，但他仍有残留的室间隔缺损和右室流出道梗阻。未观察到肺动脉高压或右心室功能障碍。术前肺血流与全身血流之比（Qp/Qs）为 2.3。经过正压通气和充气后，左心室与右心室的分流量减少，根据肺动脉和全身动脉血气分析计算，Qp/Qs接近1.0。对于保留右心室功能、左至右心室分流、肺血管阻力不高的法洛四联症患者来说，腹腔镜手术可能是可以忍受的。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.