先天性大动脉转位:双心脏瓣膜置换术的麻醉管理

Bingling Dai, Xiang Liu, Xiang Zhao, Evelyne Bischof, Jiajun Ding, Huihong Lu
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引用次数: 0

摘要

目的先天性大动脉转位矫正术(ccTGA)是一种罕见疾病,可并发各种快速性心律失常或房室传导阻滞和心脏畸形。麻醉管理是一项挑战,尤其是对伴有并发症的ccTGA患者。方法采用多模式全身麻醉联合胸横肌平面阻滞(TTMPB)、使用小剂量阿片类药物和辅助药物、肺保护性通气、使用血管活性药物和严密的围术期监测,对该患者进行围术期管理。结论对于因ccTGA接受二次心脏手术的患者,术前评估ccTGA的病因非常重要。基于手术方法和术中生命体征的麻醉管理以及术后实时监测对这些患者的术后恢复也至关重要。
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Congenitally corrected transposition of great arteries: anaesthesia management for a double heart valve replacement

Purpose

Congenitally corrected transposition of the great arteries (ccTGA) is a rare disease that is complicated by a variety of tachyarrhythmias or atrioventricular blocks and cardiac malformations. Anesthesia management is a challenge, especially in ccTGA patients with complications. Herein, we reported a case of ccTGA.

Methods

Multimodal general anesthesia combined with transversus thoracic muscle plane block (TTMPB), use of low-dose opioids and adjuvant medications, lung protective ventilation, use of vasoactive drugs and close perioperative monitoring were employed for the peri-operative management of this patient.

Results

The patient was safely returned to the ward and did not develop serious complications. Fourteen days after surgery, the patient recovered well and was discharged.

Conclusions

For patients undergoing a secondary cardiac surgery for ccTGA, preoperative evaluation of etiology of ccTGA is very important. Anesthesia management based on the surgical method and intraoperative vital signs and the postoperative real-time monitoring are also crucial for the post-operative recovery of these patients.

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