Single-Ventricle Patient: Pathophysiology and Anesthetic Management

Evaluation of Cardiac Function During Laparoscopic Gastrostomy in Pediatric Patients with Hypoplastic Left Heart Syndrome Using Intraoperative Transesophageal Echocardiography

“…For example, the Sano modification eliminates diastolic runoff into the pulmonary circulation and potentially improves coronary perfusion pressure. 12 Selection of the specific procedure is patient and institution specific. With each surgical option, there is frequently an imbalance in the ratio of pulmonary to systemic blood flow, which is determined by the balance between the pulmonary and systemic vascular resistances.…”

Spinal Anesthesia in Circumcision Operation in a Child with Bidirectional Superior Cavapulmonary Shunt

“…BCPS has become an important intermediate step in the treatment of pediatric patients with a single ventricular physiology who are ultimately destined for palliative surgery (1) .…”

“…The physiologic rationale for a bidirectional cavapulmonary shunt (Glenn prosedure) was presented clinically in 1950 (1) . In the classic Glenn procedure, flow from the superior vena cava (SVC) was directed into the right pulmonary artery, which was disconnected from the confluence.…”

“…Anesthetic management of patients presenting with BCPS is centered on the maintenance of the balance between pulmonary vascular (PVR) and systemic vascular resistance (SVR) (1) . In these patients any factor that would increase intrathoracic pressure (such as coughing, positive pressure ventilation, breath holding) or PVR (acidosis, sympathetic stimulation, intubation) can reduce flow through pulmonary circuit.…”

Laparoscopic surgery in children with congenital heart disease

“…For example, there were no patients who underwent laparoscopy emergently or while the patient was unstable. One open procedure was performed to salvage an unstable patient with tracheal esophageal atresia who had an Of the common cardiac defects, those belonging to the category termed single-ventricle physiology [3,4] are the most debilitating. These children have an imbalance of pulmonary and systemic blood flow, commonly resulting in heart failure and hypoxemia [5].…”