Open AccessAnesthetic considerations for video-assisted thoracoscopic surgery in a child with Glenn shunt for thoracic duct ligation and pleurodesis
Author(s) -
Bhavna Kakkar,
Munisha Agarwal,
Aakanksha Sehgal,
Neelam Prasad Govil
Publication year - 2018
Publication title -
saudi journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/sja.sja_395_17
Subject(s) - medicine , chylothorax , surgery , pleurodesis , cardiothoracic surgery , shunt (medical) , ligation , thoracic duct , thoracoscopy , perioperative , anesthesia , pneumothorax , lymphatic system , immunology
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.