Perioperative management of a patient with Dandy Walker malformation with tetralogy of Fallot undergoing total correction and fresh homologous pericardial pulmonary valve conduit implantation: Report of a rare case

• Main Authors: Vishnu Datt, D K Tempe, Parin Lalwani, Saket Aggarwal, Pradeep Kumar, Anitha Diwakar, A S Tomar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Annals of Cardiac Anaesthesia
• Subjects: Anesthetic management; Cardiopulmonary bypass; Dandy-Walker malformation; Homologous pulmonary valve conduit; Tetralogy of Fallot
• Online Access: http://www.annals.in/article.asp?issn=0971-9784;year=2015;volume=18;issue=3;spage=433;epage=436;aulast=Datt

Perioperative management of a patient with Dandy-Walker malformation (DWM) with tetralogy of Fallot (TOF), patent ductus arteriosus, and pulmonary artery stenosis is a great challenge to the anesthesiologist. Anesthetic management in such patients can trigger tet spells that might rapidly increase intracranial pressure (ICP), conning and even death. The increase in ICP can precipitate tet spells and further brain hypoxia. To avoid an increase in ICP during TOF corrective surgery ventriculo-peritoneal (VP) shunt should be performed before cardiac surgery. We present the first case report of a 11-month-old male baby afflicted with DWM and TOF who underwent successful TOF total corrective surgery and fresh autologous pericardial pulmonary valve conduit implantation under cardiopulmonary bypass after 1 week of VP shunt insertion.