Document Detail


Successful thoracoscopic repair of esophageal atresia with tracheoesophageal fistula in a newborn with single ventricle physiology.
MedLine Citation:
PMID:  16192508     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A neonate with VACTERL association including tricuspid atresia was scheduled for thoracoscopic esophageal atresia with tracheoesophageal fistula (EA/TEF) repair and laparoscopic gastrostomy tube placement. In addition to standard noninvasive monitoring, arterial blood pressure, central venous pressure, and cerebral oxygen saturation were monitored. Gastric distension resulting from positive pressure ventilation prevented laparoscopic gastrostomy tube placement. Thoracoscopy with a CO2 insufflation pressure of 6 mm Hg at low flow (1 L/min) was well tolerated hemodynamically despite hypercarbia and cerebral oxygen saturation was maintained. Careful monitoring and good communication were critical to the safe management of this single ventricle patient during thoracoscopic EA/TEF repair. IMPLICATIONS: Esophageal and tracheoesophageal fistula in conjunction with single ventricle physiology carries a significant risk of mortality. We present the anesthetic management of a neonate with unpalliated tricuspid atresia who underwent thoracoscopic tracheoesophageal fistula repair.
Authors:
Edward R Mariano; Larry F Chu; Craig T Albanese; Chandra Ramamoorthy
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  101     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-29     Completed Date:  2005-10-21     Revised Date:  2009-09-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-2, table of contents     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia, University of California at San Diego School of Medicine, San Diego, California 92103-8770, USA. ermariano@ucsd.edu
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MeSH Terms
Descriptor/Qualifier:
Esophageal Atresia / surgery*
Heart Defects, Congenital / surgery*
Humans
Infant, Newborn
Oxygen / metabolism
Thoracoscopy / methods*
Tracheoesophageal Fistula / surgery*
Vascular Resistance
Grant Support
ID/Acronym/Agency:
K23 GM071400-02/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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