Giant negative T-waves in hypoplastic left heart syndrome after surgery: a report on two pediatric cases

Takesue Miyuki, Tanaka Yuto, Omiya Hiroki, Fujinaka Waso, Takatori Makoto

doi:10.11478/jscva.2021-2-007

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Other Title

術後に巨大陰性T波を呈した左心低形成症候群の小児2症例
ジュツゴニキョダイインセイ Tハオテイシタサシンテイケイセイショウコウグンノショウニ 2 ショウレイ

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Abstract

<p>　We report two cases of 10-month-old and 2-year-old girls with hypoplastic left heart syndrome (HLHS) who have a history of Norwood and bidirectional Glenn operations.</p><p>　They both underwent bidirectional Glenn operation and laparotomy cholecystectomy, and their electrocardiograms (ECGs) showed giant negative T-waves with QT prolongation during postoperative management in the intensive care unit (ICU). HLHS patients have a risk of coronary ischemia. However, the ECG changes did not lead to any vital changes, so we treated the patients conservatively. Transthoracic echocardiography (TTE) performed on the 2-year-old patient showed global hypocardia. For both cases, the N-terminal pro b-type natriuretic peptide (NTproBNP) levels were elevated, but creatine kinase levels were within the reference value. The ECG changes improved tendency within a few days, and TTE performed after that showed no reduction of ventricle ejection fraction. We surmise that the observed giant negative T-waves may be stress-induced.</p>

Journal

Cardiovascular Anesthesia

Cardiovascular Anesthesia 26 (1), 27-31, 2022-09-01

Japanese Society of Cardiovascular Anesthesiologists

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