Regional cerebral oxygenation monitoring--intraoperative management in a patient with severe left ventricular dysfunction.
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.
Ing
Richard J
RJ
Department of Anaesthesiology, Red Cross War Memorial Children's Hospital and University of Cape Town, South Africa. richzing@yahoo.com
Fischer
Stephanie
S
Shipton
Steve
S
Gray
Rebecca
R
Thomas
Jenny
J
Hewitson
John
J
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*