[Anaesthesia in an adult patient with a congenitally corrected transposition of the great arteries].
A 27 year old woman suffering from a congenitally corrected transposition of the great arteries was admitted for vitrectomy due to progressive diabetic retinopathy. The congenitally corrected transposition of the great arteries is a rare form of congenital heart disease based on malrotation of the embryonic cardiac tube with complete atrio-ventricular and ventriculo-arterial discordance. The anatomic right ventricle with the tricuspidal valve supports the systemic circulation and tends to decompensation. The patient had undergone several episodes of cardiac decompensation and the implantation of a DDD-type pacemaker because of a. v. block III degrees in the past. General anaesthesia has to be performed under invasive monitoring to recognize and treat cardiocircular problems as soon as possible. The anaesthetic management of our patient included careful preoperative cardiac evaluation, insertion of arterial cannula and central venous catheter under local anaesthesia and sedation and total intravenous anaesthesia with propofol and remifentanil. No major complications were observed.
Hennes
O
O
Klinik für Anästhesiologie u. operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany. olaf.hennes@t-online.de
Breucking
E
E
D000328:Adult; D000768:Anesthesia, General; D002405:Catheterization, Central Venous; D003930:Diabetic Retinopathy / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial; D013902:Radiography, Thoracic; D014188:Transposition of Great Vessels / Q000150:complications* / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000150:complications; D014821:Vitrectomy
Narkose bei einer 27-jährigen Patientin mit einer kongenital korrigierten Transposition der grossen Arterien.