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Acute ST changes during anesthesia induction 10 months after norwood procedure
Author(s) -
Hill James A.,
Qureshi Athar M.,
Latson Larry A.
Publication year - 2011
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.23191
Subject(s) - medicine , hypoplastic left heart syndrome , norwood procedure , aorta , anastomosis , angioplasty , stenosis , cardiology , surgery , stent , anesthesia , heart disease
After the Norwood procedure for palliation of hypoplastic left heart syndrome, there is still significant interstage and late mortality with often unclear etiology. An important, but possibly under‐recognized complication of the Norwood operation is the potential for coronary insufficiency from pre‐coronary stenosis due to kinking or scarring at the anastomosis between the native and neo‐aorta. We report a case of a clinically thriving 10‐month old infant status post bidirectional Glenn who had acute ischemic changes on electrocardiogram (ECG) during induction of anesthesia for elective bilateral herniorrhaphy. A discrete narrowing in the native aorta to neo‐aorta anastomosis was identified. A stent was placed emergently to restore adequate coronary blood flow after failure of simple angioplasty to adequately improve the stenosis. © 2011 Wiley Periodicals, Inc.