Deutsch Nina, Swink Jonathan, Matisoff Andrew J, Olivieri Laura J, Cross Russell R, Waberski Andrew T, Unegbu Chinwe, Cronin Ileen F, Kanter Joshua P, Schwartz Jamie M
Division of Anesthesiology, Pain, and Perioperative Medicine, Children's National Medical Center, Washington, District of Columbia.
Division of Cardiology, Children's National Medical Center, Washington, District of Columbia.
Paediatr Anaesth. 2019 Jan;29(1):8-15. doi: 10.1111/pan.13512. Epub 2018 Oct 29.
Cardiac catheterization is an integral part of medical management for pediatric patients with congenital heart disease. Owing to age and lack of cooperation in children who need this procedure, general anesthesia is typically required. These patients have increased anesthesia risk secondary to cardiac pathology. Furthermore, multiple catheterization procedures result in exposure to harmful ionizing radiation. Magnetic resonance imaging-guided right-heart catheterization offers decreased radiation exposure and diagnostic imaging benefits over traditional fluoroscopy but potentially increases anesthetic complexity and risk. We describe our early experience with anesthetic techniques and challenges for pediatric magnetic resonance imaging-guided right-heart catheterization.
心脏导管插入术是先天性心脏病儿科患者医疗管理的一个重要组成部分。由于需要进行该手术的儿童年龄小且不配合,通常需要全身麻醉。这些患者因心脏病变而使麻醉风险增加。此外,多次导管插入术会导致暴露于有害的电离辐射中。与传统荧光透视法相比,磁共振成像引导下的右心导管插入术可减少辐射暴露并具有诊断成像优势,但可能会增加麻醉的复杂性和风险。我们描述了我们在儿科磁共振成像引导下右心导管插入术的麻醉技术和挑战方面的早期经验。