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一名患有未经矫正的成人先天性心脏病的患者因急诊腹腔镜子宫切除术面临的麻醉挑战及经食管超声心动图引导下的围手术期管理。

Anaesthetic Challenges and Transesophageal Echocardiography-Guided Perioperative Management in a Patient with Uncorrected Adult Congenital Heart Disease Presenting for Emergency Laparoscopic Hysterectomy.

作者信息

Waje Niranjan Dilip, Chatterjee Nilay, Arora Nishant Ram, Kumar Vijay

机构信息

Cardiothoracic and Liver Transplant Unit, Reliance Hospital, Kopar Khairane, Navi Mumbai, India.

Department of Anaesthetics, Yeovil District Hospital, Higher Kingston, Yeovil, United Kingdom.

出版信息

Turk J Anaesthesiol Reanim. 2021 Apr;49(2):169-174. doi: 10.5152/TJAR.2020.373. Epub 2020 Dec 24.

DOI:10.5152/TJAR.2020.373
PMID:33997849
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8098740/
Abstract

Anaesthetic management of a patient with adult congenital heart disease with a single ventricle physiology presenting for an emergency laparoscopic surgery is challenging. The importance of a multidisciplinary approach, astute understanding of the pathophysiology and optimisation of intraoperative hemodynamic goals cannot be overemphasised. The present report describes the anaesthetic challenges and the role of transoesophageal echocardiography in perioperative management of a patient with uncorrected tetralogy of Fallot with pulmonary atresia, who successfully underwent an emergency laparoscopic hysterectomy under general anaesthesia.

摘要

为一名具有单心室生理的成人先天性心脏病患者进行急诊腹腔镜手术的麻醉管理具有挑战性。多学科方法、对病理生理学的敏锐理解以及术中血流动力学目标的优化的重要性再怎么强调也不为过。本报告描述了麻醉挑战以及经食管超声心动图在一名患有肺动脉闭锁的法洛四联症未矫正患者围手术期管理中的作用,该患者在全身麻醉下成功接受了急诊腹腔镜子宫切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5502/8098740/06bc0102ee2c/TJAR-49-2-169-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5502/8098740/637b3028f27a/TJAR-49-2-169-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5502/8098740/ebfe7f39001a/TJAR-49-2-169-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5502/8098740/06bc0102ee2c/TJAR-49-2-169-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5502/8098740/637b3028f27a/TJAR-49-2-169-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5502/8098740/ebfe7f39001a/TJAR-49-2-169-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5502/8098740/06bc0102ee2c/TJAR-49-2-169-g03.jpg

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Anaesthetic Challenges and Transesophageal Echocardiography-Guided Perioperative Management in a Patient with Uncorrected Adult Congenital Heart Disease Presenting for Emergency Laparoscopic Hysterectomy.一名患有未经矫正的成人先天性心脏病的患者因急诊腹腔镜子宫切除术面临的麻醉挑战及经食管超声心动图引导下的围手术期管理。
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本文引用的文献

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Abdominal Compliance and Laparoscopy: A Review.腹部顺应性与腹腔镜检查:综述
JSLS. 2019 Jan-Mar;23(1). doi: 10.4293/JSLS.2018.00080.
2
A case series of different anesthesia approaches for single ventricular physiology patients in various stages of palliation underwent noncardiac procedures.一组针对处于不同姑息治疗阶段的单心室生理患者采用不同麻醉方法进行非心脏手术的病例系列。
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Laparoscopic colectomy in an adult with single ventricle physiology: anesthetic implications and management.
单心室生理的成人患者行腹腔镜结肠切除术:麻醉影响及管理
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Echocardiographic assessment of preload responsiveness in critically ill patients.超声心动图评估危重症患者前负荷反应性。
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Uncorrected tetralogy of Fallot in an 86-year-old patient.一名86岁患者的未经矫正的法洛四联症。
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Prevalence and optimal management strategy for aortic regurgitation in tetralogy of Fallot.法洛四联症中主动脉反流的患病率及最佳管理策略
Eur J Cardiothorac Surg. 2004 Dec;26(6):1080-6. doi: 10.1016/j.ejcts.2004.08.025.
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Anaesthetic implications of grown-up congenital heart disease.成人先天性心脏病的麻醉要点
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The incidence of congenital heart disease.先天性心脏病的发病率。
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