Sedation for transcatheter replacement of Melody® pulmonary valve: Case report

  • Guiomar Fernández-Castellano Anesthesiology and Resuscitation, Hospitales Universitarios Virgen del Rocío, Seville, Spain
  • Daniel López-Herrera-Rodríguez Anesthesiology and Resuscitation, Hospitales Universitarios Virgen del Rocío, Seville, Spain
  • Alejandro Domínguez Anesthesiology and Resuscitation, Hospitales Universitarios Virgen del Rocío, Seville, Spain
  • Francisco Sánchez-Carillo Anesthesiology and Resuscitation, Hospitales Universitarios Virgen del Rocío, Seville, Spain
Keywords: Deep sedation, Pulmonary valve, Transposition of great vessels, Fistula, Anesthesia

Abstract

Introduction: Valved conduits for surgically reconstructing the outflow tract of the right ventricle have improved the prognosis for certain congenital heart diseases. When they become dysfunctional, transcatheter pulmonary valve replacement is safe and effective.

Clinical findings, diagnostic evaluation and interventions: We report the case of a 21 years old female patient diagnosed with transposition of great vessels corrected in childhood. After several surgeries, she presents a dysfunction of the right ventricle. In response, a "Melody" pulmonary valve was implanted percutaneously under deep sedation.

Conclusion: The ideal anesthetic technique for transcatheter pulmonary valve replacement is controversial. There is a debate over the merits of general anesthesia and deep sedation. Each case must be decided on after a careful preoperative evaluation, considering the risk/benefit and patient cooperation. The experience at our center using deep sedation is promising, but we have an alternative plan to convert to general anesthesia if necessary.

References

1. Shinkawa T, Chipman C, Bozzay T, Gossett JM, Imamura M. Outcome of right ventricle to pulmonary artery conduit for biventricular repair. Ann Thorac Surg. 2015;99:1357-66.

2. Raju V,Burkhart HM, Durham LA, Eidem BW, Phillips SD, Li Z, et al. Reoperation after arterial switch: a 27-year experience. ANN Thorac Surg. 2013;95:2015-22.

3. Suárez de Lezo J, Pan M, Romero M, Segura J, Ojeda S, Suárez J, et al. Intervencionismo percutáneo en cardiopatías congénitas. Obstrucciones del tracto de salida de ambos ventrículos. Cardiocore. 2013;48:102-12.

4. oByrne ML, Gillespie MJ. Will catheter interventions replace surgery for valve abnormalities? Curr Opin Cardiol. 2014;29:83-90.

5. Molina-Méndez FJ, Lesrpon-Robles MC. Manejo anestésico para el remplazo de la válvula aórtica transcatéter. Rev Mex Anestesiol. 2013;36:112-5.

6. Covello RD, Maj G, Landoni G, Guarracino F, Bigmani F, Gonfalini F, et al. Transcatheter implantation of an aortic valve: anesthesiological management. Minerva Anestesiol. 2010;76:100-8.

7. Ruggery L, Gerli C, Franco A, Barile L, Magnano di San Lio MS, Villari N, et al. Anhestesic managament for percutaneous aortic valve implantation: an overview of worldwide experiences. HSR Proc Intensive Care Cardiovasc Anesth. 2012;4:40-6.

8. Rincón IE. Manejo anestésico del niño con cardiopatía durante el cateterismo cardíaco. Rev Colomb Anestesiol. 1996;24:359-64.

9. Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Semin Cardiothorac Vasc Anesth 2007;11:274-81.
How to Cite
1.
Fernández-Castellano G, López-Herrera-Rodríguez D, Domínguez A, Sánchez-Carillo F. Sedation for transcatheter replacement of Melody® pulmonary valve: Case report. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021May10];45(Supplement):55 -8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/459

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Published
2017-04-01
How to Cite
1.
Fernández-Castellano G, López-Herrera-Rodríguez D, Domínguez A, Sánchez-Carillo F. Sedation for transcatheter replacement of Melody® pulmonary valve: Case report. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021May10];45(Supplement):55 -8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/459
Section
Case Report / Case Series

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