Campbell Matthew, Tull Okola U, Islam Zulqar, Sakharpe Ashish, Bailey Caryl
Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, USA.
SAGE Open Med Case Rep. 2025 Mar 22;13:2050313X251328764. doi: 10.1177/2050313X251328764. eCollection 2025.
With only about 3% of patients with uncorrected tetralogy of Fallot surviving past age 40, we describe the case of an uncorrected tetralogy of Fallot following a palliative, now obstructed, Blalock-Taussig shunt in a man who presented for emergent noncardiac surgery. Due to limited in-house records, managing this complex patient presentation required obtaining outside-hospital records, performing point-of-care diagnostic studies, and coordinating with the surgical team. We employed monitored anesthesia care with the option to convert to general anesthesia if needed. The patient was discharged after a 3-day intensive care unit stay and cleared for normal activity at his 3-week follow-up. This case highlights the importance of interdisciplinary collaboration, knowledge of prior surgical history, and understanding intraoperative hemodynamic goals for successful planning and perioperative management.
只有约3%的法洛四联症未矫治患者能活到40岁以上，我们在此描述一例法洛四联症未矫治患者的病例，该患者曾接受姑息性、现已梗阻的布莱洛克-陶西格分流术，此次因非心脏急诊手术前来就诊。由于医院内部记录有限，处理这一复杂的患者情况需要获取院外记录、进行床旁诊断检查，并与手术团队协调。我们采用了监护下麻醉管理，必要时可转为全身麻醉。患者在重症监护病房住院3天后出院，3周后随访时恢复正常活动。该病例凸显了跨学科协作、了解既往手术史以及理解术中血流动力学目标对于成功规划和围手术期管理的重要性。
