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All Journal E-Jurnal Medika Udayana Syntax Literate: Jurnal Ilmiah Indonesia PREPOTIF : Jurnal Kesehatan Masyarakat Indonesian Journal of Anesthesiology and Reanimation (IJAR) JOURNAL LA MEDIHEALTICO Majalah Anestesia & Critical Care (MACC)
Kurniyanta, I Putu
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Humanities Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences Veterinary Other

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Optimizing Anesthesia for a Pediatric Patient with Cyanotic Heart Disease: Pulmonary Atresia with MAPCAs Putra, Kadek Agus Heryana; Kurniyanta, I Putu; Subagiartha, I Made; Akbar, Lalu Reza Aldira
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i2.57739

Abstract

Pulmonary atresia with major aortopulmonary collateral arteries (MAPCAs) is a rare and complex congenital heart anomaly marked by the absence of a direct connection between the right ventricle and the pulmonary arteries. The pulmonary blood supply originates via collateral arteries that arise from the aorta. Pulmonary atresia with major aortopulmonary collateral arteries (MAPCAs) poses considerable difficulties in perioperative management, especially during general anesthesia for dental procedures in pediatric patients. This case report details the anesthetic management of a 5-year-old male with pulmonary atresia and MAPCAs undergoing dental extractions under general anesthesia. The anesthetic plan prioritized maintaining systemic blood pressure to ensure pulmonary perfusion, avoiding increases in pulmonary vascular resistance, and preventing myocardial depression. Anesthesia was induced with ketamine and fentanyl, while maintenance was achieved using sevoflurane and dexmedetomidine, with pressure-controlled ventilation to optimize hemodynamics. Postoperative recovery was uneventful, with the patient monitored in the pediatric intensive care unit. The management of patients with pulmonary atresia and MAPCAs requires careful planning and a multidisciplinary approach. A tailored anesthetic strategy emphasizing hemodynamic stability and oxygenation is critical. This report underscores the importance of understanding the pathophysiology of MAPCAs to optimize perioperative outcomes.
Co-Authors Akbar, Lalu Reza Aldira Burhan Fikrawan, Putu Filla Jaya Giovanni, Malvin I Ketut Sinardja I Made Gede Widnyana I Made Prema Putra I Made Subagiartha I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Bagus Krisna Jaya Sutawan Jimmy Wongkar Kadek Agus Heryana Putra, Kadek Agus Made Wiryana Paskalis, Timothy Pratiwi, Made Sindy Astri Putu Herdita Sudiantara, Putu Herdita Putu Pramana Suarjaya Senapathi, Tjokorda Sidemen, I Gusti Putu Sukrama Sidemen, IGP Sukrana Suranadi , I Wayan Thomas, Vinsensius Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Widyana, I Made Gede Yustisia, Putu Ngurah Krisna Denta