Acute pulmonary hypertension complicating the arterial switch procedure
Freeman, J. ; DeLeon, S. Y. ; Miles, R. H. ; Downey, F. X. ; Hofstra, J. ; Quinones, J. A. ; Fisher, E. A. ; Pifarre, R.
Springer
Published 1995
Springer
Published 1995
| ISSN: |
1432-1971
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|---|---|
| Keywords: |
Pulmonary hypertension ; Transposition ; Arterial switch
|
| Source: |
Springer Online Journal Archives 1860-2000
|
| Topics: |
Medicine
|
| Notes: |
Abstract Two neonates undergoing arterial switch procedure developed life-threatening pulmonary hypertension intraoperatively. In one patient, bradycardia, hypotension, and electrocardiographic (ECG) evidence of myocardial ischemia suddenly occurred 20 minutes after uneventful weaning from cardiopulmonary bypass. Lifting a palpably hypertensive main pulmonary artery (MPA) resulted in reproducible hemodynamic improvement. Because the patient was already on full ventilatory support and a nitroglycerin infusion, the MPA was suspended onto the anterior chest wall. In the other patient, after removal of intraoperative drapes, severe generalized swelling and cyanosis were noted. The central venous pressure had risen to 25 mmHg, and the PO2 had dropped to 52 mmHg on 100% FIO2. The systolic arterial pressure and ECG remained normal. Immediate reexploration revealed a palpably hypertensive MPA. The coronary arteries implanted more laterally on the neoaorta were uncompromised. Amrinone loading and infusion produced immediate improvement. We believe that surgeons should be aware that pulmonary hypertension can cause coronary artery compression and right heart failure in neonates undergoing the arterial switch procedure. Lateral placement of the coronary artery and aggressive use of pulmonary vasodilators can minimize the problem.
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| Type of Medium: |
Electronic Resource
|
| URL: |
| _version_ | 1798295867253325824 |
|---|---|
| autor | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. |
| autorsonst | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. |
| book_url | http://dx.doi.org/10.1007/BF00798066 |
| datenlieferant | nat_lic_papers |
| hauptsatz | hsatz_simple |
| identnr | NLM207156514 |
| iqvoc_descriptor_keyword | iqvoc_00000520:switch |
| iqvoc_descriptor_title | iqvoc_00000520:switch |
| issn | 1432-1971 |
| journal_name | Pediatric cardiology |
| materialart | 1 |
| notes | Abstract Two neonates undergoing arterial switch procedure developed life-threatening pulmonary hypertension intraoperatively. In one patient, bradycardia, hypotension, and electrocardiographic (ECG) evidence of myocardial ischemia suddenly occurred 20 minutes after uneventful weaning from cardiopulmonary bypass. Lifting a palpably hypertensive main pulmonary artery (MPA) resulted in reproducible hemodynamic improvement. Because the patient was already on full ventilatory support and a nitroglycerin infusion, the MPA was suspended onto the anterior chest wall. In the other patient, after removal of intraoperative drapes, severe generalized swelling and cyanosis were noted. The central venous pressure had risen to 25 mmHg, and the PO2 had dropped to 52 mmHg on 100% FIO2. The systolic arterial pressure and ECG remained normal. Immediate reexploration revealed a palpably hypertensive MPA. The coronary arteries implanted more laterally on the neoaorta were uncompromised. Amrinone loading and infusion produced immediate improvement. We believe that surgeons should be aware that pulmonary hypertension can cause coronary artery compression and right heart failure in neonates undergoing the arterial switch procedure. Lateral placement of the coronary artery and aggressive use of pulmonary vasodilators can minimize the problem. |
| package_name | Springer |
| publikationsjahr_anzeige | 1995 |
| publikationsjahr_facette | 1995 |
| publikationsjahr_intervall | 8004:1995-1999 |
| publikationsjahr_sort | 1995 |
| publisher | Springer |
| reference | 16 (1995), S. 297-300 |
| schlagwort | Pulmonary hypertension Transposition Arterial switch |
| search_space | articles |
| shingle_author_1 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. |
| shingle_author_2 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. |
| shingle_author_3 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. |
| shingle_author_4 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. |
| shingle_catch_all_1 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. Acute pulmonary hypertension complicating the arterial switch procedure Pulmonary hypertension Transposition Arterial switch Pulmonary hypertension Transposition Arterial switch Abstract Two neonates undergoing arterial switch procedure developed life-threatening pulmonary hypertension intraoperatively. In one patient, bradycardia, hypotension, and electrocardiographic (ECG) evidence of myocardial ischemia suddenly occurred 20 minutes after uneventful weaning from cardiopulmonary bypass. Lifting a palpably hypertensive main pulmonary artery (MPA) resulted in reproducible hemodynamic improvement. Because the patient was already on full ventilatory support and a nitroglycerin infusion, the MPA was suspended onto the anterior chest wall. In the other patient, after removal of intraoperative drapes, severe generalized swelling and cyanosis were noted. The central venous pressure had risen to 25 mmHg, and the PO2 had dropped to 52 mmHg on 100% FIO2. The systolic arterial pressure and ECG remained normal. Immediate reexploration revealed a palpably hypertensive MPA. The coronary arteries implanted more laterally on the neoaorta were uncompromised. Amrinone loading and infusion produced immediate improvement. We believe that surgeons should be aware that pulmonary hypertension can cause coronary artery compression and right heart failure in neonates undergoing the arterial switch procedure. Lateral placement of the coronary artery and aggressive use of pulmonary vasodilators can minimize the problem. 1432-1971 14321971 Springer |
| shingle_catch_all_2 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. Acute pulmonary hypertension complicating the arterial switch procedure Pulmonary hypertension Transposition Arterial switch Pulmonary hypertension Transposition Arterial switch Abstract Two neonates undergoing arterial switch procedure developed life-threatening pulmonary hypertension intraoperatively. In one patient, bradycardia, hypotension, and electrocardiographic (ECG) evidence of myocardial ischemia suddenly occurred 20 minutes after uneventful weaning from cardiopulmonary bypass. Lifting a palpably hypertensive main pulmonary artery (MPA) resulted in reproducible hemodynamic improvement. Because the patient was already on full ventilatory support and a nitroglycerin infusion, the MPA was suspended onto the anterior chest wall. In the other patient, after removal of intraoperative drapes, severe generalized swelling and cyanosis were noted. The central venous pressure had risen to 25 mmHg, and the PO2 had dropped to 52 mmHg on 100% FIO2. The systolic arterial pressure and ECG remained normal. Immediate reexploration revealed a palpably hypertensive MPA. The coronary arteries implanted more laterally on the neoaorta were uncompromised. Amrinone loading and infusion produced immediate improvement. We believe that surgeons should be aware that pulmonary hypertension can cause coronary artery compression and right heart failure in neonates undergoing the arterial switch procedure. Lateral placement of the coronary artery and aggressive use of pulmonary vasodilators can minimize the problem. 1432-1971 14321971 Springer |
| shingle_catch_all_3 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. Acute pulmonary hypertension complicating the arterial switch procedure Pulmonary hypertension Transposition Arterial switch Pulmonary hypertension Transposition Arterial switch Abstract Two neonates undergoing arterial switch procedure developed life-threatening pulmonary hypertension intraoperatively. In one patient, bradycardia, hypotension, and electrocardiographic (ECG) evidence of myocardial ischemia suddenly occurred 20 minutes after uneventful weaning from cardiopulmonary bypass. Lifting a palpably hypertensive main pulmonary artery (MPA) resulted in reproducible hemodynamic improvement. Because the patient was already on full ventilatory support and a nitroglycerin infusion, the MPA was suspended onto the anterior chest wall. In the other patient, after removal of intraoperative drapes, severe generalized swelling and cyanosis were noted. The central venous pressure had risen to 25 mmHg, and the PO2 had dropped to 52 mmHg on 100% FIO2. The systolic arterial pressure and ECG remained normal. Immediate reexploration revealed a palpably hypertensive MPA. The coronary arteries implanted more laterally on the neoaorta were uncompromised. Amrinone loading and infusion produced immediate improvement. We believe that surgeons should be aware that pulmonary hypertension can cause coronary artery compression and right heart failure in neonates undergoing the arterial switch procedure. Lateral placement of the coronary artery and aggressive use of pulmonary vasodilators can minimize the problem. 1432-1971 14321971 Springer |
| shingle_catch_all_4 | Freeman, J. DeLeon, S. Y. Miles, R. H. Downey, F. X. Hofstra, J. Quinones, J. A. Fisher, E. A. Pifarre, R. Acute pulmonary hypertension complicating the arterial switch procedure Pulmonary hypertension Transposition Arterial switch Pulmonary hypertension Transposition Arterial switch Abstract Two neonates undergoing arterial switch procedure developed life-threatening pulmonary hypertension intraoperatively. In one patient, bradycardia, hypotension, and electrocardiographic (ECG) evidence of myocardial ischemia suddenly occurred 20 minutes after uneventful weaning from cardiopulmonary bypass. Lifting a palpably hypertensive main pulmonary artery (MPA) resulted in reproducible hemodynamic improvement. Because the patient was already on full ventilatory support and a nitroglycerin infusion, the MPA was suspended onto the anterior chest wall. In the other patient, after removal of intraoperative drapes, severe generalized swelling and cyanosis were noted. The central venous pressure had risen to 25 mmHg, and the PO2 had dropped to 52 mmHg on 100% FIO2. The systolic arterial pressure and ECG remained normal. Immediate reexploration revealed a palpably hypertensive MPA. The coronary arteries implanted more laterally on the neoaorta were uncompromised. Amrinone loading and infusion produced immediate improvement. We believe that surgeons should be aware that pulmonary hypertension can cause coronary artery compression and right heart failure in neonates undergoing the arterial switch procedure. Lateral placement of the coronary artery and aggressive use of pulmonary vasodilators can minimize the problem. 1432-1971 14321971 Springer |
| shingle_title_1 | Acute pulmonary hypertension complicating the arterial switch procedure |
| shingle_title_2 | Acute pulmonary hypertension complicating the arterial switch procedure |
| shingle_title_3 | Acute pulmonary hypertension complicating the arterial switch procedure |
| shingle_title_4 | Acute pulmonary hypertension complicating the arterial switch procedure |
| sigel_instance_filter | dkfz geomar wilbert ipn albert fhp |
| source_archive | Springer Online Journal Archives 1860-2000 |
| timestamp | 2024-05-06T09:43:01.424Z |
| titel | Acute pulmonary hypertension complicating the arterial switch procedure |
| titel_suche | Acute pulmonary hypertension complicating the arterial switch procedure |
| topic | WW-YZ |
| uid | nat_lic_papers_NLM207156514 |