Anesthetic considerations for video-assisted thoracoscopic surgery in a child with Glenn shunt for thoracic duct ligation and pleurodesis

Glenn shunt is an anastomosis between superior vena cava and right pulmonary artery to palliate patients with single ventricle physiology of the heart. Chylothorax is a frequent and troublesome complication after the creation of this shunt, which if not controlled with medical management, might requ...

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Bibliographic Details
Published in:Saudi journal of anaesthesia 2018-01, Vol.12 (1), p.131-133
Main Authors: Kakkar, Bhavna, Agarwal, Munisha, Sehgal, Aakanksha, Govil, Neelam
Format: Article
Language:English
Subjects:
Analysis
Anesthesia
Case Report
Central nervous system agents
Chylothorax
Glenn shunt
pleurodesis and thoracic duct ligation
video-assisted thoracoscopic surgery
Congenital diseases
Heart
Heart rate
Hospitals
Lungs
Ostomy
Pediatrics
Physiology
Pulmonary arteries
Surgery
Thoracic surgery
Veins & arteries
Ventilators
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Description
Summary:Glenn shunt is an anastomosis between superior vena cava and right pulmonary artery to palliate patients with single ventricle physiology of the heart. Chylothorax is a frequent and troublesome complication after the creation of this shunt, which if not controlled with medical management, might require pleurodesis, and thoracic duct ligation. Video-assisted thoracoscopic surgery (VATS) causes less postoperative pain, earlier mobilization, lower overall morbidity, a shortened hospital stay with reduced cost, and a cosmetic incision. A comprehensive understanding of physiology of Glenn shunt and implications of the proposed surgical procedure (VATS) is necessary to plan the anesthetic agents, cardiovascular drugs, ventilation strategies, and other perioperative factors.
ISSN:1658-354X
0975-3125
DOI:10.4103/sja.SJA_395_17