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Anaesthesia management of interventional cardiac catheterisation for pulmonary atresia with intact ventricular septum and critical pulmonary stenosis: a retrospective analysis

Published online by Cambridge University Press:  24 May 2024

Xu Zhang Open the ORCID record for Xu Zhang [Opens in a new window] ,
Ning Zhang ,
Kui-liang Wang  and
Yue-yi Ren
Xu Zhang
Affiliation:
Department of Anesthesiology, Peking University People’s Hospital, Women and Children’s Hospital, Qingdao University, Qingdao, China
Ning Zhang
Affiliation:
Department of Laboratory Medicine, Qingdao Women’s and Children’s Hospital Affiliated to Qingdao University, Qingdao, China
Kui-liang Wang
Affiliation:
Department of Heart Center, Qingdao Women’s and Children’s Hospital Affiliated to Qingdao University, Qingdao, China
Yue-yi Ren*
Affiliation:
Department of Heart Center, Qingdao Women’s and Children’s Hospital Affiliated to Qingdao University, Qingdao, China
*
Corresponding author: Y-y. Ren; Email: xxgmz1173@126.com
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Abstract

Objective:

Pulmonary atresia with intact ventricular septum and critical pulmonary stenosis usually have to undergo treatment in the neonatal period. Compared to traditional surgical intervention, catheter-based cardiac interventions may achieve similar or superior outcomes for neonates with pulmonary atresia with intact ventricular septum and critical pulmonary stenosis. However, there is limited literature on anaesthesia techniques, challenges, and risks associated with cardiac catheterisation in this population.

Methods:

This article retrospectively analysed the clinical data of pulmonary atresia with intact ventricular septum and critical pulmonary stenosis neonates who were treated with interventional cardiac catheterisation in our hospital from January 2015 to October 2022. Clinical outcomes considered were haemodynamic or pulse oxygen saturation instability, vasoactive requirements, prolonged intubation (>24 h postoperatively), and cardiovascular adverse events.

Results:

A total of 63 patients met the inclusion criteria. All patients survived the intervention. Among the patients with critical pulmonary stenosis, 40 successfully received percutaneous balloon pulmonary valvuloplasty, while three patients received ductal stenting due to moderate right ventricular dysplasia at the same time. For patients with pulmonary atresia with intact ventricular septum, 17 of the 23 patients successfully underwent percutaneous pulmonary valve perforation and percutaneous balloon pulmonary valvuloplasty. Of these, five patients underwent ductal stenting due to unstable pulmonary blood flow. Three patients only underwent ductal stenting. In addition, three patients received hybrid therapy.

Conclusions:

There are various clinical techniques and risk challenges in the interventional cardiac catheterisation of neonatal pulmonary atresia with intact ventricular septum and critical pulmonary stenosis. However, by mastering the physiological and pathophysiological characteristics of the disease, adequately preparing for the perioperative period, and predicting the procedure process and potential complications, anaesthesia and surgical risks can be effectively managed.

Keywords

pulmonary atresia with intact ventricular septumcritical pulmonary stenosisneonatecatheterisationanaesthesia management
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 8
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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