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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia ISM (Intisari Sains Medis) : Jurnal Kedokteran PREPOTIF : Jurnal Kesehatan Masyarakat Indonesian Journal of Anesthesiology and Reanimation (IJAR) Majalah Anestesia & Critical Care (MACC)
Kadek Agus Heryana Putra, Kadek Agus
Bagian/SMF Ilmu Anestesi Dan Terapi Intensif RSUP Sanglah, Fakultas Kedokteran Universitas Udayana
Humanities Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences Other

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Journal : Syntax Literate: Jurnal Ilmiah Indonesia

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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 Adinda Putra Pradhana Akbar, Lalu Reza Aldira Arisadika, Putu Bagus Aryasa EM, Tjahya Burhan Cynthia Dewi Sinardja Damayanti, Elok Dewi, I Dewa Ayu Mas Shintya Dharmawan, IGB Adi Gede Semarawima, Gede Giovanni, Malvin Hartawan, IGAG Utara I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Made Agus Kresna Sucandra I Made Gede Widnyana I Made Subagiartha I Wayan Suranadi Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Jeanne, Bianca Ketut Semara Jaya, Ketut Semara Kurnia, Prajnaariayi Prawira Kurniyanta, I Putu Kusuma, Dian Reginalda Made Agus Kresna Sucandra, Made Agus Kresna Made Wiryana Marilaeta Cindryani, Marilaeta Ni Luh Gede Apsari Pararesthi Ni Made Supradnyawati, Ni Made Pontisomaya Parami Putra, Putu Enggi Pradana Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Putu Pramana Suarjaya Ratumasa, Marilaeta Cindryani Ra Ratumasa, Marilaeta Cindryani Ra , Sidemen, I Gusti Putu Sukrama Sidemen, IGP Sukrana Sobhana Shanmuganathan Suastika, I Gede Juli Suranadi , I Wayan Thius, Adi Dharma Tirta, Ian Tjokorda Gde Agung Senapathi Widyana, I Made Gede