Downey Laura, Rodriguez Samuel, Clendenin David
From the Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
A A Case Rep. 2014 Sep 1;3(5):61-4. doi: 10.1213/XAA.0000000000000080.
We present the case of a 20-year-old woman with a history of hypoplastic left heart syndrome, D-transposition of the great arteries, and mitral/pulmonary valve atresia without surgical palliation, who was admitted with persistent atrial flutter/fibrillation and worsening cardiac function from amiodarone-induced thyrotoxicosis. Despite maximal medical therapy, she continued to have uncontrolled thyrotoxicosis and underwent successful emergent thyroidectomy under general anesthesia. With advances in the treatment of congenital heart disease, more patients are surviving to adulthood and require emergent noncardiac surgery. Therefore, anesthesiologists must understand the principles for managing patients with congenital heart disease and how the patient's physiology may affect the anesthetic plan.
我们报告了一名20岁女性的病例，她有左心发育不全综合征、大动脉D型转位和二尖瓣/肺动脉瓣闭锁病史，未接受过手术姑息治疗，因持续性心房扑动/颤动以及胺碘酮诱发的甲状腺毒症导致心功能恶化而入院。尽管进行了最大程度的药物治疗，但她的甲状腺毒症仍未得到控制，并在全身麻醉下成功接受了急诊甲状腺切除术。随着先天性心脏病治疗方法的进步，越来越多的患者存活至成年并需要进行急诊非心脏手术。因此，麻醉医生必须了解先天性心脏病患者的管理原则以及患者的生理状况如何影响麻醉计划。
