Key result
Tight hemodynamic and respiratory control enables safe general anesthesia in pediatric kyphoscoliosis with large ASD.
Why the study?
Anaesthesia management strategies for patients with congenital kyphoscoliosis and large atrial septal defect undergoing corrective surgery require careful consideration to prevent complications.
Case Report (n=1)
Careful anaesthetic management avoiding increases in pulmonary and systemic vascular resistance is crucial for patients with large atrial septal defects and pulmonary hypertension undergoing major corrective surgery.
Supports careful anaesthetic planning in congenital heart disease with spinal deformity; leaves open need for systematic evaluation.
The authors present the anaesthesia management of a 12-year female patient who underwent corrective surgery for kyphoscoliosis under general anaesthesia.The patient had congenital idiopathic kyphoscoliosis with left lateral curvature (left convex), C7-hemivertebrae, large atrial septal defect with left to right shunt (ostium secundum defect of 24 mm), mild pulmonary hypertension with mean pulmonary artery systolic pressure (PASP) of 39 mmHg, and dilated right heart.The authors gave general anaesthesia with vigilant monitoring of haemodynamic parameters (heart rate, ECG, blood pressure, spO 2 ), EtCO 2 , and peak inspiratory pressures; avoided medicines that stimulate the sympathetic system, and normothermia was ensured.Urine output was monitored.The authors prevented hypoxia, hypercarbia, and acidosis; avoided positive end-expiratory pressure (PEEP), air bubbles in IV fluids or medicines, and factors that cause a rise in systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR); all of these are the target goals for anaesthesia management in a patient with congenital kyphoscoliosis and atrial septal defect.
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A 2025 study conducted a case report in Congenital idiopathic kyphoscoliosis and large atrial septal defect (n=1). General anaesthesia management was evaluated. General anaesthesia was successfully managed in a 12-year-old female with congenital kyphoscoliosis and a large atrial septal defect by avoiding hypoxia, hypercarbia, acidosis, and PEEP.
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