Saglık Bilimleri Universitesi 1. Uluslararasi Anesteziyoloji ve Reanimasyon Sempozyumu, İstanbul, Turkey, 3 - 04 December 2021, pp.259
INTRODUCTION - PURPOSE: Hypoplastic Left Heart Syndrome (HSCS) is a congenital heart
lesion that is almost fatal if left untreated. We aimed to present the anesthesia management of a
HSCS case operated under general anesthesia due to multiple dental caries in our clinic, in the
light of the literature.
CASE: 6 years old, 17 kg patient had 3 serial open heart operations (atrial septectomy and
pulmonary banding) when she was 1 month old. Preoperative consultations were requested for the
patient with transposed type double outlet right ventricle, high sinus venosus type ASD. Infective
endocarditis prophylaxis was performed. After obtaining written consent from the family, standard
anesthesia monitoring was performed. Peripheral SO2:83, BP:120/70 mmHg, pulse: 110-120
beats/min. sinus rhythm in room air. After preoxygenation with 4 lt/min O2 for 2 minutes, the
patient was administered 1mg midazolam, 10mg ketamine, followed by 10mcg fentanyl and 8mg
rocuronium, and was nasally intubated with a 5.0 spiral tube. Anesthesia was maintained with 0.8
mac sevoflurane, 3 lt/min fresh gas (80% O2, 20% medical air) and the patient's intraoperative
peripheral SO2 values ranged between 85-88. Local anesthetic was administered by the surgeon
before and at the end of the surgery. In addition, 200 mg of paracetamol was administered. In the
patient who was extubated under deep anesthesia, 40 mg of suggammadex was administered to
the patient simultaneously with the closure of sevoflurane. The spontaneously breathing patient
was taken to the recovery unit. In the follow-up, the patient with GCS 15, conscious oriented,
cooperative, o2 unsupported so2 84 was sent to the service.
DISCUSSION - CONCLUSION: Adequate oxygenation/ventilation and pain control should be
provided to prevent pulmonary hypertension as well as maintaining adequate preload in the
anesthesia management of patients with congenital heart diseases such as HSCS. Postoperative
dehydration and reduced preload should be avoided.