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Anesthetic management of pial synangiosis and intracranial hemorrhage with a Fontan circulation
Author(s) -
SUBRAMANIAM BALACHUNDHAR,
SORIANO SULPICIO G.,
MICHAEL SCOTT R.,
KUSSMAN BARRY D.
Publication year - 2006
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2005.01598.x
Subject(s) - medicine , craniotomy , tricuspid atresia , anesthesia , intracranial pressure , fontan procedure , cerebral circulation , surgery , cardiology , heart disease
Summary We report the case of a 11‐year‐old girl with Moyamoya syndrome, who had undergone staged‐repair of tricuspid atresia to a Fontan circulation, scheduled to undergo bilateral pial synangiosis. Surgery for the first hemisphere was complicated by intracranial hemorrhage requiring an emergency craniotomy. The case highlights the importance of understanding Fontan physiology and its interrelationship with the cerebral circulation in the setting of cerebrovascular insufficiency and raised intracranial pressure.