1. Emergency deep hypothermic circulatory arrest in a 1-year-old undergoing cardiac surgery in a Nigerian hospital - anaesthesia and critical care interventions.
- Author
-
Ikenga CS, Sahu B, Okwulehie V, and Umeh F
- Subjects
- Anesthesia methods, Cardiovascular Abnormalities diagnosis, Critical Care methods, Female, Humans, Infant, Nigeria, Subclavian Artery surgery, Treatment Outcome, Cardiovascular Abnormalities surgery, Circulatory Arrest, Deep Hypothermia Induced methods, Ductus Arteriosus, Patent surgery, Heart Septal Defects, Ventricular surgery, Subclavian Artery abnormalities
- Abstract
Deep Hypothermic Circulatory Arrest (DHCA) is a technique used to obtain optimal operating conditions while providing cerebral protection. The case report presented a DHCA on an infant that was basically done as an emergency in an attempt to correct a previously unrecognized anomaly. We report a case of a 1-year-old that had surgery for Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDA) ligation but following closure was noted to have no palpable peripheral pulses, only carotid pulsation. This necessitated an emergency reopening of the chest. Close inspection revealed an interrupted aortic arch with aberrant right subclavian artery and pre-surgery PDA supplying both upper and lower limb. DHCA was immediately commenced and the patient cooled to 16°C. The surgeon promptly set out to attach the subclavian artery to the ascending aorta and descending aorta. At the completion of the surgery, the patient was taken to Intensive Care Unit (ICU) for critical care support. She was subsequently discharged after spending a little more than a week in ICU. This procedure is rarely done as an emergency but was instituted in our case in effort to immediately achieve perfusion to the limbs. As the expertise to carry out the procedure is limited, it might be better to develop ways to efficiently ensure the skill set is continually updated., Competing Interests: The authors declare no competing interests., (Copyright: Chidiebele Samuel Ikenga et al.)
- Published
- 2020
- Full Text
- View/download PDF