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Chapter 41 - Pulmonary Hypertension and Congenital Heart Disease

from Section 7 - Miscellaneous Lesions and Syndromes

Published online by Cambridge University Press:  09 September 2021

Laura K. Berenstain
Affiliation:
Cincinnati Children's Hospital Medical Center
James P. Spaeth
Affiliation:
Cincinnati Children's Hospital Medical Center
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Summary

The risk of perioperative morbidity and mortality is increased in patients with pulmonary hypertension regardless of the procedure. This is particularly true for patients with multifactorial pulmonary hypertension. We present such a patient here with a history of Down syndrome and repaired congenital heart disease who is scheduled to undergo an elective tympanoplasty. Anesthetic issues relevant to the care of a patient with Down syndrome, atrioventricular septal defect, and pulmonary hypertension are discussed, with a focus on assessment and intraoperative planning.

Type
Chapter
Information
Congenital Cardiac Anesthesia
A Case-based Approach
, pp. 314 - 322
Publisher: Cambridge University Press
Print publication year: 2021

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References

Suggested Reading

Adachi, I., Uemura, H., McCarthy, K. P., et al. Surgical anatomy of atrioventricular septal defect. Asian Cardiovasc Thorac Ann 2008; 16: 497502.CrossRefGoogle ScholarPubMed
Bush, D., Galambos, C., Ivy, D. D., et al. Clinical characteristics and risk factors for developing pulmonary hypertension in children with Down syndrome. J Pediatr 2018; 202: 212–19.CrossRefGoogle ScholarPubMed
Hansmann, G. and Apitz, C. Treatment of children with pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. Heart 2016; 102: ii67–ii85.Google ScholarPubMed
Shukla, A. C. and Almodovar, M. C. Anesthesia considerations for children with pulmonary hypertension. Pediatr Crit Care Med 2010; 11: S773.CrossRefGoogle ScholarPubMed
Twite, M. D. and Friesen, R. H. The anesthetic management of children with pulmonary hypertension in the cardiac catheterization laboratory. Anesthesiol Clin 2014; 23: 157–73.Google Scholar

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