Perioperative and Anesthetic Considerations in Interrupted Aortic Arch
| Autor: | Nelson Burbano-Vera, Viviane G. Nasr, Katherine L. Zaleski, Gregory J. Latham |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Heart Defects
Congenital medicine.medical_specialty Aorta Thoracic 030204 cardiovascular system & hematology Intracardiac injection Perioperative Care law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law Internal medicine medicine.artery Ductus arteriosus medicine Humans Anesthesia Prostaglandin E1 business.industry Interrupted aortic arch Infant Newborn Perioperative medicine.disease Intensive care unit Anesthesiology and Pain Medicine medicine.anatomical_structure 030228 respiratory system chemistry Descending aorta cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | Seminars in cardiothoracic and vascular anesthesia. 22(3) |
| ISSN: | 1940-5596 |
| Popis: | Interrupted aortic arch (IAA) is defined as the loss of luminal continuity between the ascending and descending aorta and is classified based on the anatomic level of interruption. IAA is associated with a number of intracardiac anomalies with the most common being patent ductus arteriosus, ventricular septal defect, and left ventricular outflow obstruction. There is also a strong association between type B interruption and 22q11 deletion syndrome. The perioperative management of the neonate with IAA begins in the intensive care unit with optimization of end-organ perfusion and function. Survival depends on the prompt initiation of prostaglandin E1 in order to maintain ductal patency, careful management of the patient’s ratio of pulmonary to systemic blood flow (Qp:Qs), and a thorough understanding of the physiologic implications of the surgical plan, type of interruption, and associated syndromes and anomalies. This review will focus on the anatomy, physiology, and perioperative anesthetic management considerations specific to the management of IAA. |
| Databáze: | OpenAIRE |
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