title: Regional cerebral oxygenation monitoring--intraoperative management in a patient with severe left ventricular dysfunction.
abstract: Intraoperative near-infrared spectroscopy cerebral oxygenation monitoring assists intraoperative decision-making in environments without extracorporeal membrane oxygenation (ECMO), left ventricular assist device (LVAD) or access to cardiac transplantation. We report a case of an anomalous left coronary artery arising from the pulmonary artery (ALCAPA), undergoing cardiac surgery. A 4-month-old infant presented in extremis with cardiac failure. We discuss the pathophysiology and challenging intraoperative management of ALCAPA with extensive ischaemia and myocardial infarction.
authors.affiliation: Department of Anaesthesiology, Red Cross War Memorial Children's Hospital and University of Cape Town, South Africa. richzing@yahoo.com
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Ing
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fischer
authors.forename: Steve
authors.initials: S
authors.lastname: Shipton
authors.forename: Rebecca
authors.initials: R
authors.lastname: Gray
authors.forename: Jenny
authors.initials: J
authors.lastname: Thomas
authors.forename: John
authors.initials: J
authors.lastname: Hewitson
mesh_terms: D001026:Coronary Artery Bypass; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007223:Infant; D007430:Intraoperative Care; D016343:Monitoring, Intraoperative / Q000379:methods; D019265:Spectroscopy, Near-Infrared; D014188:Transposition of Great Vessels / Q000601:surgery*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*