Anesthesia record.
Induction and maintenance of general anesthesia were performed with nitrous oxide, oxygen and sevoflurane. Blood pressure decreased immediately after intubation, but recovered to normal range after administration of 4 mg etilephrine. The concentration of end-tidal carbon dioxide tended to be high during artificial ventilation, but returned to a normal level after recovery of spontaneous breathing. Slight fever during anesthesia subsided without medication after awakening.
ECG during anesthesia.
Regular rhythm was maintained during anesthesia. The electric axis deviation was suggested in leads II of the ECG.
Hypoplastic left heart syndrome (HLHS).
Hypoplasia and dysfunction were seen in the left ventricle and base of the aorta. ASD and PDA were also found.
PDA: patent ductus arteriosus, ASD: atrial septal defect.
Norwood operation.
This operation is the first stage in the serial surgical treatment. The purpose of this operation is to reduce blood flow resistance from the RV to the A or PA. PDA and the base of the PA are separated from the PA and connected to the A. Blood returns to the PA passes the RV-PA conduit.
Fontan operation.
The SVC has been separated from RA and connected to PA in the Glenn operation, which is performed prior to the Fontan operation. In this operation, the IVC is also separated from the RA and connected to the PA. Several modified methods are applied in connection of the SVC, IVC, and PA. This figure shows the method of using an extracardiac conduit for connecting the IVC and PA. In this configuration, arterial and venous blood is no longer mixed.
Relationship between preoperative baPWV and coefficent of variation of perioperative SBP (CVSBP) during general anesthesia with propofol or sevoflurane.
Preoperative baPWV had significant positive correlations with CVSBP.
The gradient of the regression line between preoperative baPWV and CVSBP with Group S is greater than that of Group P.
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