Preoperative management of the neonate with critical aortic valvar stenosis.
Cardiol Young
; 24(6): 1111-6, 2014 Dec.
Article
em En
| MEDLINE
| ID: mdl-25647388
ABSTRACT
Neonatal critical aortic stenosis is a rare form of CHD that often presents with cardiogenic shock. Although surgical and cardiac catheterisation-based interventions have been successful in alleviating left ventricular outflow tract obstruction, it remains associated with high morbidity and mortality. Critical aortic stenosis results in elevated left ventricular wall stress, which ultimately increases myocardial oxygen consumption and disrupts coronary artery perfusion during diastole, leading to ventricular dysfunction and cardiogenic shock. Critical care management before definitive intervention should be tailored to optimising oxygen delivery and reducing metabolic consumption of the myocardium and peripheral organ systems. This can be accomplished with prostaglandin infusion to maintain system perfusion through patency of the arterial duct, inotropic support, mechanical ventilation, and central nervous system abrogation. Management should also include a multi-specialty medical team including paediatric cardiothoracic surgeons and paediatric cardiologists with expertise in cardiac catheterisation, imaging, and transplantation.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Respiração Artificial
/
Vasoconstritores
/
Vasodilatadores
/
Cuidados Pré-Operatórios
/
Alprostadil
/
Cardiotônicos
/
Cardiopatias Congênitas
Limite:
Humans
/
Newborn
Idioma:
En
Revista:
Cardiol Young
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
PEDIATRIA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Estados Unidos