Key result
An adolescent with repaired truncus arteriosus developed sudden and profound hypotension during posterior spinal fusion, confirmed as an anaphylactic reaction to Surgiflo.
Case Report (n=1)
Highlights the risk of anaphylaxis to gelatin-containing hemostatic agents like Surgiflo during noncardiac surgery in patients with complex congenital heart disease, and the utility of echocardiography in managing cardiovascular effects.
Clinicians should consider anaphylaxis to gelatin hemostats in congenital heart disease; leaves open need for systematic perioperative safety data.
Anaphylactic reaction to gelatin-containing hemostatic agents has been reported in the orthopedic literature, most commonly during scoliosis repair in adolescents. However, the risk, differential diagnosis, and management of anaphylaxis in patients with complex congenital heart disease undergoing noncardiac procedures have not been previously reported. We describe the case of an adolescent with a history of repaired truncus arteriosus undergoing posterior spinal fusion who developed sudden and profound hypotension that was ultimately confirmed to be an anaphylactic reaction to Surgiflo. Echocardiography was used to aid in diagnosis and management of the cardiovascular effects of anaphylaxis in this patient with residual cardiac pathophysiology.
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Espinel et al. (2017) conducted a case report in Anaphylaxis to Surgiflo in complex congenital heart disease (n=1). Surgiflo was evaluated on Anaphylactic reaction (sudden and profound hypotension). An adolescent with repaired truncus arteriosus developed sudden and profound hypotension during posterior spinal fusion, confirmed as an anaphylactic reaction to Surgiflo.
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