Anesthetic considerations for video-assisted thoracoscopic surgery in a child with Glenn shunt for thoracic duct ligation and pleurodesis

对于接受Glenn分流术的儿童,行胸导管结扎和胸膜固定术时,视频辅助胸腔镜手术的麻醉注意事项。

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Abstract

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.

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