A case of anesthesia for the repair of complete ectopia cordis covered with skin grafts in the neonatal period

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  • 新生児期に植皮片で心被覆をした完全型心臓脱の修復の麻酔経験
  • シンセイジキ ニ ショクヒヘン デ シン ヒフク オ シタ カンゼンガタ シンゾウ ダツ ノ シュウフク ノ マスイ ケイケン

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Abstract

<p>　A 9-month-old female infant was diagnosed with incomplete Cantrell syndrome with complete ectopia cordis accompanied by congenital heart defects including tetralogy of Fallot, cor triatriatum, and an unroofed coronary sinus. She was provided coverage for her heart with split thickness skin grafts after birth, and she underwent intracardiac repair and chest wall reconstruction using musculocutaneous flaps 9 months later. The long-term use of cardiopulmonary bypass for dissecting adhesions of the heart to the chest wall and repairing the complex congenital heart defects in the malposition contributed to coagulopathy and myocardial edema. The latter caused cardiac ventricular diastolic dysfunction, leading to decreased cardiac output on covering the sternal defect with a polytetrafluoroethylene sheet. Continuous epinephrine infusion and release of a part of the coverage preserved the cardiac output. Reconstruction of the chest wall was accomplished postoperatively using musculocutaneous flaps on day 11 after improving the myocardial edema with continuous hemodiafiltration.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 26 (1), 21-25, 2022-09-01

    Japanese Society of Cardiovascular Anesthesiologists

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