The Bland-White-Garland syndrome. Clinical picture and anaesthesiological management.
We report a five-month-old infant with an impaired left ventricular ejection fraction as a result of Bland-White-Garland-syndrome (BWGS). Total intravenous anaesthesia with fentanyl and midazolam was used as the anaesthetic technique. After aortic reimplantation of the left coronary artery, weaning from cardiopulmonary bypass (CPB) was prolonged and was only successfully managed with high dose noradrenaline, dopamine and dobutamine. Persistent myocardial dysfunction led to prolonged intensive care treatment. Seven months after surgery, left ventricular function and clinical condition have improved significantly.
Kleinschmidt
S
S
Department of Anaesthesiology and Critical Care Medicine, University of Saarland, Homburg, Saar, Germany.
Grueness
V
V
Molter
G
G
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001011:Aorta / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery; D003422:Critical Care; D004280:Dobutamine / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D005283:Fentanyl / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D009638:Norepinephrine / Q000627:therapeutic use; D013318:Stroke Volume; D013577:Syndrome; D018487:Ventricular Dysfunction, Left / Q000209:etiology
D000316:Adrenergic alpha-Agonists; D018686:Anesthetics, Intravenous; D002316:Cardiotonic Agents; D004280:Dobutamine; D008874:Midazolam; D005283:Fentanyl; D004298:Dopamine; D009638:Norepinephrine