To investigate the perioperative anesthesia management of percutaneous pulmonary valve implantation (PPVI).
Clinical data of 6 patients undergoing PPVI operation were retrospectively analyzed in children's heart center of Henan Provincial People's Hospital from December 2017 to January 2020, including 3 males and 3 females with mean age (16.3±5.4) years,weight 41.2±12.3Kg. All patients received endotracheal intubation under general anesthesia. Systolic blood pressure (SBP) and diastolic blood pressure (DBP),heart rate(HR),central venous pressure(CVP),pulse oxygen saturation(SPO2) were recorded before anesthesia induction (T1),after anesthesia induction (T2),before surgery (T3),before percutaneous pulmonary valve implantation (T4),during percutaneous pulmonary valve implantation (T5),after percutaneous pulmonary valve implantation (T6) and out of the operating room (T7). Right ventricular systolic (SRVP) and right ventricular diastolic (DRVP), pulmonary artery systolic (SPAP) and diastolic (DPAP) were recorded before T4 and after T6. Intraoperative complications were recorded. The time of tracheal catheter removal was recorded. The time of stay in ICU and the time of discharge was recorded.
Compared with T1,T2,T3,T4,T6,T7,SBP,DBP,HR and SPO2 was significantly reduced at T5 (P<0.05). Compared with T1,T2,T3,T4,T5, CVP was significantly reduced at T6 and T7 (P<0.05). Compared with T4, Right ventricular diastolic pressure (DRVP) was significantly reduced and pulmonary artery diastolic pressure (DPAP) was significantly increased at T6 (P<0.05). All patients were able to tolerate general anesthesia. One patient was transferred directly to the ward without any complications related to anesthesia and surgery. Five patients were transferred to ICU and 6 patients were discharged successfully.
Tracheal intubation general anesthesia is suitable for percutaneous PPVI surgery. Hemodynamic monitoring should be strengthened during pulmonary valve implantation to maintain circulatory stability.
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