title: Anesthetic management of infants with palliated hypoplastic left heart syndrome undergoing laparoscopic nissen fundoplication.
abstract: The safety of laparoscopic surgery in infants with single ventricle physiology has been a subject of controversy despite potential benefits over open surgery. We present the anesthetic management of five infants with palliated hypoplastic left heart syndrome that underwent laparoscopic Nissen fundoplication. After anesthetic induction and tracheal intubation, an intraarterial catheter was placed for hemodynamic monitoring. Insufflation pressure was limited to 12 mm Hg and was well tolerated by all patients. There were no intraoperative or postoperative complications. In patients with hypoplastic left heart syndrome, laparoscopic Nissen fundoplication can be safely performed with careful patient selection and close intraoperative monitoring.
authors.affiliation: Department of Anesthesia, University of California at San Diego School of Medicine, San Diego, California; Department of Anesthesia, Department of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Mariano
authors.forename: M Gail
authors.initials: MG
authors.lastname: Boltz
authors.forename: Craig T
authors.initials: CT
authors.lastname: Albanese
authors.forename: Claire T
authors.initials: CT
authors.lastname: Abrajano
authors.forename: Chandra
authors.initials: C
authors.lastname: Ramamoorthy
mesh_terms: D000768:Anesthesia, General; D001784:Blood Gas Analysis; D005260:Female; D018662:Fundoplication; D006439:Hemodynamics; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000150:complications* / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D016343:Monitoring, Intraoperative