scholarly journals Anesthetic Management in Patient with Suspected Brain Abscess, Atrium Septal Defect, and Eisenmenger Syndrome

2021 ◽  
Vol 4 (4) ◽  
Author(s):  
Galantry Ahmad Azhari ◽  
◽  
Budiana Rismawan
Keyword(s):  
Intracranial Pressure ◽  
Brain Abscess ◽  
Septal Defect ◽  
Heart Defects ◽  
Brain Infarction ◽  
Anesthetic Management ◽  
Eisenmenger Syndrome ◽  
Preoperative Management ◽  
Increased Intracranial Pressure ◽  
Anesthesia Monitoring

Introduction: Patients with congenital heart disease especially with systemic shunting between systemic and pulmonary circulation often develop pulmonary hypertension and left-to-right shunt (Eisenmenger syndrome) if left untreated. These patients are at risk of developing spontaneous brain abscess due to brain infarction caused by polycythemia, impaired immune function, and loss of lung phagocytosis. Such patients were often admitted to the emergency room with signs of increased intracranial pressure (ICP), and needed specific consideration during surgery. Case: a 31-year old female diagnosed with intracranial space occupying lesion (SOL) due to suspected brain abscess with concurrent heart defects (atrial septal defect / ASD and Eisenmenger syndrome) was consulted to the operating theatre for emergency burrhole aspiration. The surgery was performed for an hour and the postoperatively the patient was admitted to the intensive care unit (ICU). Conclusion: perioperative management of patients with brain abscess and concurrent ASD and Eisenmenger syndrome consists of preoperative management, methods of anesthesia, monitoring, and interventions to prevent the worsening of left-to-right shunt and increasing intracranial pressure. These managements consist of optimal pain management, perioperative oxygen therapy, and prevention of precipitating factor that increases left-to-right shunting.

scholarly journals Anesthetic Management in Patient with Suspected Brain Abscess, Atrium Septal Defect, and Eisenmenger Syndrome

2021 ◽  
Author(s):  
Galantry Ahmad Azhari ◽  
Budiana Rismawan
Keyword(s):  
Intracranial Pressure ◽  
Brain Abscess ◽  
Septal Defect ◽  
Heart Defects ◽  
Brain Infarction ◽  
Anesthetic Management ◽  
Eisenmenger Syndrome ◽  
Preoperative Management ◽  
Increased Intracranial Pressure ◽  
Anesthesia Monitoring

Introduction: Patients with congenital heart disease especially with systemic shunting between systemic and pulmonary circulation often develop pulmonary hypertension and left-to-right shunt (Eisenmenger syndrome) if left untreated. These patients are at risk of developing spontaneous brain abscess due to brain infarction caused by polycythemia, impaired immune function, and loss of lung phagocytosis. Such patients were often admitted to the emergency room with signs of increased intracranial pressure (ICP), and needed specific consideration during surgery. Case: a 31-year old female diagnosed with intracranial space occupying lesion (SOL) due to suspected brain abscess with concurrent heart defects (atrial septal defect / ASD and Eisenmenger syndrome) was consulted to the operating theatre for emergency burrhole aspiration. The surgery was performed for an hour and the postoperatively the patient was admitted to the intensive care unit (ICU). Conclusion: perioperative management of patients with brain abscess and concurrent ASD and Eisenmenger syndrome consists of preoperative management, methods of anesthesia, monitoring, and interventions to prevent the worsening of left-to-right shunt and increasing intracranial pressure. These managements consist of optimal pain management, perioperative oxygen therapy, and prevention of precipitating factor that increases left-to-right shunting.

scholarly journals A Case of Transposition of Great Arteries with Ventricular Septal Defect and Mesocardia Presenting for Neurosurgery

2019 ◽  
Vol 10 (04) ◽  
pp. 715-717
Author(s):  
Soniya Biswas ◽  
Keta Thakkar ◽  
Neeraja Ajayan ◽  
Ajay Prasad Hrishi ◽  
Manikandan Sethuraman
Keyword(s):  
Ventricular Septal Defect ◽  
Brain Abscess ◽  
Vascular Resistance ◽  
Septal Defect ◽  
Anesthetic Management ◽  
Air Embolism ◽  
Paradoxical Embolism ◽  
Systemic Complications ◽  
Transposition Of Great Arteries ◽  
Congenitally Corrected Transposition

AbstractCongenitally corrected transposition of great arteries (CC-TGAs) associated with a ventricular septal defect (VSD) presents with cyanotic spells and systemic complications such as brain abscess. In mesocardia, the heart lies in the midline with no apex seen on the left side. We report the anesthetic management of a child with CC-TGA, VSD, and mesocardia presenting with parietal brain abscess for neurosurgery. The significant anesthetic challenges include maintenance of peripheral vascular resistance lower than systemic vascular resistance, prevention of air embolism and paradoxical embolism, avoidance of hyperviscosity in addition to avoiding any rise in intracranial pressure, and maintenance of cerebral perfusion pressure.

Dental Management of the Down and Eisenmenger Syndrome Patient

2004 ◽  
Vol 5 (2) ◽  
pp. 70-80 ◽  
Author(s):  
Evelyn M. Chung ◽  
Eric C. Sung ◽  
Kari L. Sakurai
Keyword(s):  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Ductus Arteriosus ◽  
Medical Complications ◽  
Eisenmenger Syndrome ◽  
Syndrome Patient ◽  
Septal Defects ◽  
Dental Management ◽  
Work Up

Abstract About 40% to 50% of Down syndrome (DS) patients can have significant congenital heart defects such as patent ductus arteriosus, Tetralogy of Fallot, and septal defects. Patients with large septal defects may develop Eisenmenger syndrome (ES), which is defined by the cardiac septal defect and pulmonary hypertension coupled with a reverse right to left shunting of blood flow. DS patients that suffer from this condition require special considerations in the delivery of their dental care to prevent further medical complications or emergencies such as infection, cyanotic episodes, and thromboemboli. Collaboration with the cardiologist is also essential to ensure a complete and comprehensive pre-operative work up. The purpose of this article is to describe the dental management of DS patients with ES under general anesthesia. Citation Chung EM, Sung EC, Sakurai KL. Dental Management of the Down and Eisenmenger Syndrome Patient. J Contemp Dent Pract 2004 May;(5)2:070-080.

Case Report Onventricular Septal Defect (VSD) with Pulmonary Hypertention (Eisenmenger Syndrome) with LSCS

2021 ◽  
pp. 238-242
Author(s):  
Bali Thool ◽  
Shalini Lokhande
Keyword(s):  
Case Report ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Heart Defects ◽  
Eisenmenger Syndrome ◽  
Heart Defect ◽  
Lower Segment Cesarean Section ◽  
First Choice ◽  
Chief Complaints ◽  
History Of

Background: A ventricular septal defect is a defect of the ventricular septal wall where the abnormal opening is present in between the two ventricles. Eisenmenger syndrome is a condition it may develop due to unrepaired heart defect and complication of unrepaired heart defect who is born congenitally. The congenital heart defects lead to Eisenmenger syndrome it developed due to abnormal blood circulate throughout the heart and lungs. Case Report: The 23-year-old female was admitted to AVBRH with the chief complaints of a history of amenorrhoea since 8 months, complaints of breathlessness during exertion since the 7th month of pregnancy and she was referred to AVBRH from Amravati on date 27/1/2021. At the age of 14 years, she had a history of cyanosis at the time of fever and had recurrent episodes of fever for 2-3 yrs, lasting for 2-3 weeks. She is primigravida and had undergone LSCS on date 3/2/2021. She delivered a male child on date 3/2/2021 of birth weight 1.9kg at 12:15 pm. Discussion: Patient with pulmonary hypertension and Eisenmenger syndrome where the surgery is contraindicated because in Eisenmenger syndrome surgery is life-threatening. Only medical management is available to treat Eisenmenger syndrome. Conclusion: Ventricular septal defect in adult females where the pregnancy is contraindicated. Epidural anesthesia should be preferred while the patient undergoes the lower segment cesarean section. This case report concludes that in this condition emergency LSCS is the first choice of treatment and oxygen therapy.

scholarly journals Heart and lung transplantation in pulmonary arterial hypertension related to congenital heart disease: an unusual indication

2020 ◽  
Vol 4 (S1) ◽  
Author(s):  
Rosaria Barracano ◽  
Heba Nashat ◽  
Andrew Constantine ◽  
Konstantinos Dimopoulos
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Lung Transplantation ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Pulmonary Vascular Disease ◽  
Eisenmenger Syndrome ◽  
Pulmonary Arterial ◽  
Recurrent Haemoptysis

Abstract Background Eisenmenger syndrome is a multisystem disorder, characterised by a significant cardiac defect, severe pulmonary hypertension and long-standing cyanosis. Despite the availability of pulmonary hypertension therapies and improved supportive care in specialist centres, Eisenmenger patients are still faced with significant morbidity and mortality. Case presentation We describe the case of a 44-year-old woman with Eisenmenger syndrome secondary to a large secundum atrial septal defect. Her pulmonary vascular disease was treated with pulmonary vasodilators, but she experienced a progressive decline in exercise tolerance, increasing atrial arrhythmias, resulting in referral for transplantation. Her condition was complicated by significant recurrent haemoptysis in the context of extremely dilated pulmonary arteries and in-situ thrombosis, which prompted successful heart and lung transplantation. She made a slow recovery but remains well 3 years post-transplant. Conclusions Patients with Eisenmenger syndrome secondary to a pre-tricuspid lesion, such as an atrial septal defect have a natural history that differs to patients with post-tricuspid shunts; the disease tends to present later in life but is more aggressive, prompting early and aggressive medical intervention with pulmonary arterial hypertension therapies. This case illustrates that severe recurrent haemoptysis can be an indication for expediting transplantation in Eisenmenger syndrome patients.

scholarly journals Evaluation of cerebrovascular hemodynamics in patients with idiopathic intracranial hypertension using transcranial Doppler

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Mahmoud M. Allam ◽  
Hatem A. Almasry ◽  
Sandra M. Ahmed ◽  
Youssuf G. Taha ◽  
Mohammed I. Oraby
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Transcranial Doppler ◽  
Idiopathic Intracranial Hypertension ◽  
Pulsatility Index ◽  
Research Work ◽  
Increased Intracranial Pressure ◽  
Significant Relation ◽  
Before And After

Abstract Background Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure without a clear cause and can have serious visual effects. Previous research work suggests that transcranial Doppler measurements of pulsatility index correlate accurately with elevated intracranial pressure. Objective To assess the cerebrovascular hemodynamic changes in patients with IIH using transcranial Doppler before and after lumbar puncture and CSF withdrawal. Methods An interventional study conducted on 40 patients (31 females and 9 males) fulfilling the modified Dandy criteria for diagnosis of idiopathic intracranial hypertension, MRI brain, and MRV was done to the patients. Lumbar puncture was done for all included patients to measure intracranial pressure and CSF withdrawal. Transcranial Doppler was performed for all included before and after lumbar puncture and CSF withdrawal and the following parameters were measured: peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI). Results Significant relation was found between grades of papilledema and PSV, RI, and PI (p value 0.012, 0.025, 0.016) but no significant relation was found between grades of papilledema and EDV (0.102). Significant changes occurred in parameters of TCD pre- and post-CSF withdrawal including PSV, EDV, and PI (p value 0.001, 0.015, 0.019) denoting a significant change in cerebral hemodynamics after CSF withdrawal which denotes a decrease in intracranial pressure. Conclusion Increased intracranial pressure significantly affects cerebral blood flow. A normalization of transcranial Doppler parameters occurs following lowering of intracranial pressure through lumbar puncture and CSF withdrawal.

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