Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management
Increasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the p...
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doaj-f22ae2fcfa844d55898dd235e2fd73712020-11-25T02:34:45ZengWolters Kluwer Medknow PublicationsAnnals of Cardiac Anaesthesia0971-97842015-01-0118225225610.4103/0971-9784.154495Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and managementKelly J ZachHarish RamakrishnaKrishnashwamy ChandrasekaranRicardo A WeisIncreasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the perioperative period. Single ventricle physiology represents a delicate balance between systemic and pulmonary blood flow. Any alterations in blood flow through these systems can produce undesirable hemodynamic changes, especially during the perioperative period. We present a case of an adult patient with a single left ventricle who presented for laparoscopic total colectomy due to inflammatory bowel disease. His abnormal anatomy coupled with the hemodynamic disruptions caused by laparoscopy presented significant anesthetic challenges. We highlight the anesthetic concerns of single ventricle physiology, specifically pertaining to laparoscopic surgery. We provide recommendations for safely managing these patients perioperatively. With detailed preoperative evaluation and close hemodynamic monitoring during the perioperative period, these patients can experience successful surgical and anesthetic outcomes.http://www.annals.in/article.asp?issn=0971-9784;year=2015;volume=18;issue=2;spage=252;epage=256;aulast=ZachCardiac surgery; Coronary artery bypass grafting; European system for cardiac operative risk evaluation; Risk factorAfter drop; Extravascular lung water; Fluid balanceAnesthesia; pregnancy; pulmonary hypertensionCardiac surgery; heart disease; mortality; postoperative complications; risk stratification in cardiac surgeryCardiac anesthesia; Etomidate; PropofolCPBCardiac computerized tomographic angiography; Congenital heart disease; General anesthesiaImage quality; Induced apneaExtracorporeal membrane oxygenation; simulation; trainingMitral valve prolapse; NeoChord delivery system; three-dimensional transesophageal echocardiographyCongenital heart defect; Transesophageal echocardiogram; Tei indexCardiac surgery; dissociative anesthesia; intensive care; ketamineCardiac surgery; hospital-acquired infection; infection; procalcitonin; sepsisAortic dissection; ascending; intimo-intimal intussusception; Stanford type AAnesthesia induction; impaled knife in the back; airway managementPulmonary vascular resistance; Transesophageal echocardiography; Truncus arteriosusOn table extubation; Safety; Tetralogy of Fallot; Total correctionHigh-risk abdominal surgery; Myocardium at risk; Perioperative use of intra-aortic balloon pump; Subclavian artery stenosisProsthetic valve aortic stenosis; prosthetic valve mitral stenosis; transcatheter aortic valve replacement; transcatheterAnesthesia; Blalock-Taussig shunt; Congenital heart disease; Laparoscopic surgery; Single ventricle physiology |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kelly J Zach Harish Ramakrishna Krishnashwamy Chandrasekaran Ricardo A Weis |
spellingShingle |
Kelly J Zach Harish Ramakrishna Krishnashwamy Chandrasekaran Ricardo A Weis Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management Annals of Cardiac Anaesthesia Cardiac surgery; Coronary artery bypass grafting; European system for cardiac operative risk evaluation; Risk factor After drop; Extravascular lung water; Fluid balance Anesthesia; pregnancy; pulmonary hypertension Cardiac surgery; heart disease; mortality; postoperative complications; risk stratification in cardiac surgery Cardiac anesthesia; Etomidate; Propofol CPB Cardiac computerized tomographic angiography; Congenital heart disease; General anesthesia Image quality; Induced apnea Extracorporeal membrane oxygenation; simulation; training Mitral valve prolapse; NeoChord delivery system; three-dimensional transesophageal echocardiography Congenital heart defect; Transesophageal echocardiogram; Tei index Cardiac surgery; dissociative anesthesia; intensive care; ketamine Cardiac surgery; hospital-acquired infection; infection; procalcitonin; sepsis Aortic dissection; ascending; intimo-intimal intussusception; Stanford type A Anesthesia induction; impaled knife in the back; airway management Pulmonary vascular resistance; Transesophageal echocardiography; Truncus arteriosus On table extubation; Safety; Tetralogy of Fallot; Total correction High-risk abdominal surgery; Myocardium at risk; Perioperative use of intra-aortic balloon pump; Subclavian artery stenosis Prosthetic valve aortic stenosis; prosthetic valve mitral stenosis; transcatheter aortic valve replacement; transcatheter Anesthesia; Blalock-Taussig shunt; Congenital heart disease; Laparoscopic surgery; Single ventricle physiology |
author_facet |
Kelly J Zach Harish Ramakrishna Krishnashwamy Chandrasekaran Ricardo A Weis |
author_sort |
Kelly J Zach |
title |
Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management |
title_short |
Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management |
title_full |
Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management |
title_fullStr |
Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management |
title_full_unstemmed |
Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management |
title_sort |
laparoscopic colectomy in an adult with single ventricle physiology: anesthetic implications and management |
publisher |
Wolters Kluwer Medknow Publications |
series |
Annals of Cardiac Anaesthesia |
issn |
0971-9784 |
publishDate |
2015-01-01 |
description |
Increasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the perioperative period. Single ventricle physiology represents a delicate balance between systemic and pulmonary blood flow. Any alterations in blood flow through these systems can produce undesirable hemodynamic changes, especially during the perioperative period. We present a case of an adult patient with a single left ventricle who presented for laparoscopic total colectomy due to inflammatory bowel disease. His abnormal anatomy coupled with the hemodynamic disruptions caused by laparoscopy presented significant anesthetic challenges. We highlight the anesthetic concerns of single ventricle physiology, specifically pertaining to laparoscopic surgery. We provide recommendations for safely managing these patients perioperatively. With detailed preoperative evaluation and close hemodynamic monitoring during the perioperative period, these patients can experience successful surgical and anesthetic outcomes. |
topic |
Cardiac surgery; Coronary artery bypass grafting; European system for cardiac operative risk evaluation; Risk factor After drop; Extravascular lung water; Fluid balance Anesthesia; pregnancy; pulmonary hypertension Cardiac surgery; heart disease; mortality; postoperative complications; risk stratification in cardiac surgery Cardiac anesthesia; Etomidate; Propofol CPB Cardiac computerized tomographic angiography; Congenital heart disease; General anesthesia Image quality; Induced apnea Extracorporeal membrane oxygenation; simulation; training Mitral valve prolapse; NeoChord delivery system; three-dimensional transesophageal echocardiography Congenital heart defect; Transesophageal echocardiogram; Tei index Cardiac surgery; dissociative anesthesia; intensive care; ketamine Cardiac surgery; hospital-acquired infection; infection; procalcitonin; sepsis Aortic dissection; ascending; intimo-intimal intussusception; Stanford type A Anesthesia induction; impaled knife in the back; airway management Pulmonary vascular resistance; Transesophageal echocardiography; Truncus arteriosus On table extubation; Safety; Tetralogy of Fallot; Total correction High-risk abdominal surgery; Myocardium at risk; Perioperative use of intra-aortic balloon pump; Subclavian artery stenosis Prosthetic valve aortic stenosis; prosthetic valve mitral stenosis; transcatheter aortic valve replacement; transcatheter Anesthesia; Blalock-Taussig shunt; Congenital heart disease; Laparoscopic surgery; Single ventricle physiology |
url |
http://www.annals.in/article.asp?issn=0971-9784;year=2015;volume=18;issue=2;spage=252;epage=256;aulast=Zach |
work_keys_str_mv |
AT kellyjzach laparoscopiccolectomyinanadultwithsingleventriclephysiologyanestheticimplicationsandmanagement AT harishramakrishna laparoscopiccolectomyinanadultwithsingleventriclephysiologyanestheticimplicationsandmanagement AT krishnashwamychandrasekaran laparoscopiccolectomyinanadultwithsingleventriclephysiologyanestheticimplicationsandmanagement AT ricardoaweis laparoscopiccolectomyinanadultwithsingleventriclephysiologyanestheticimplicationsandmanagement |
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