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Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report
BACKGROUND: Double outlet right ventricle (DORV) is a rare and complex congenital heart defect, and the surgical repairs vary with type and pathophysiology consequences. Due to prolonged progressive hypoxemia, severe polycythemia is common in patients with DORV, which ultimately leads to coagulation...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Baishideng Publishing Group Inc
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040181/ https://www.ncbi.nlm.nih.gov/pubmed/33889630 http://dx.doi.org/10.12998/wjcc.v9.i11.2634 |
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author | Tan, Ling-Can Zhang, Wei-Yi Zuo, Yi-Ding Chen, Hong-Yang Jiang, Chun-Ling |
author_facet | Tan, Ling-Can Zhang, Wei-Yi Zuo, Yi-Ding Chen, Hong-Yang Jiang, Chun-Ling |
author_sort | Tan, Ling-Can |
collection | PubMed |
description | BACKGROUND: Double outlet right ventricle (DORV) is a rare and complex congenital heart defect, and the surgical repairs vary with type and pathophysiology consequences. Due to prolonged progressive hypoxemia, severe polycythemia is common in patients with DORV, which ultimately leads to coagulation dysfunction and increases the risk of thrombosis and infarction. Consequently, the anesthetic management is challenging and how to manage severe polycythemia and avoid hypoxia-related complications in such patients is of great significance. CASE SUMMARY: Herein, we report the anesthetic management of a 10-year-old female patient with a DORV. She lived in the low-oxygen Qinghai-Tibet Plateau, and presented with severe polycythemia (hemoglobin, 24.8 g/dL; hematocrit, 75%). She underwent a modified Fontan surgery, which was satisfactory and without any perioperative complications. Our anesthetic management highlights the importance of perioperative hemodilution in decreasing the risk of thromboembolism and the importance of correcting coagulopathy in preventing hemorrhage. CONCLUSION: Anesthetic management is challenging in rare cyanotic congenital heart disease patients with severe polycythemia. It is important to adopt perioperative hemodilution and correction of coagulopathy in preventing thrombosis and hemorrhage. |
format | Online Article Text |
id | pubmed-8040181 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-80401812021-04-21 Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report Tan, Ling-Can Zhang, Wei-Yi Zuo, Yi-Ding Chen, Hong-Yang Jiang, Chun-Ling World J Clin Cases Case Report BACKGROUND: Double outlet right ventricle (DORV) is a rare and complex congenital heart defect, and the surgical repairs vary with type and pathophysiology consequences. Due to prolonged progressive hypoxemia, severe polycythemia is common in patients with DORV, which ultimately leads to coagulation dysfunction and increases the risk of thrombosis and infarction. Consequently, the anesthetic management is challenging and how to manage severe polycythemia and avoid hypoxia-related complications in such patients is of great significance. CASE SUMMARY: Herein, we report the anesthetic management of a 10-year-old female patient with a DORV. She lived in the low-oxygen Qinghai-Tibet Plateau, and presented with severe polycythemia (hemoglobin, 24.8 g/dL; hematocrit, 75%). She underwent a modified Fontan surgery, which was satisfactory and without any perioperative complications. Our anesthetic management highlights the importance of perioperative hemodilution in decreasing the risk of thromboembolism and the importance of correcting coagulopathy in preventing hemorrhage. CONCLUSION: Anesthetic management is challenging in rare cyanotic congenital heart disease patients with severe polycythemia. It is important to adopt perioperative hemodilution and correction of coagulopathy in preventing thrombosis and hemorrhage. Baishideng Publishing Group Inc 2021-04-16 2021-04-16 /pmc/articles/PMC8040181/ /pubmed/33889630 http://dx.doi.org/10.12998/wjcc.v9.i11.2634 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Case Report Tan, Ling-Can Zhang, Wei-Yi Zuo, Yi-Ding Chen, Hong-Yang Jiang, Chun-Ling Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report |
title | Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report |
title_full | Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report |
title_fullStr | Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report |
title_full_unstemmed | Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report |
title_short | Anesthetic management of a child with double outlet right ventricle and severe polycythemia: A case report |
title_sort | anesthetic management of a child with double outlet right ventricle and severe polycythemia: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040181/ https://www.ncbi.nlm.nih.gov/pubmed/33889630 http://dx.doi.org/10.12998/wjcc.v9.i11.2634 |
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