[Six Cases of Anesthetic Management of Adult Patients Undergoing Coarctation of Aorta Repair].

BACKGROUND

In Japan, every year more than 9,000 patients with congenital heart disease reach adulthood due to improved medical treatments. Adult coarctation of aorta (CoA) patient is likely to need surgery for re- CoA, progressive CoA and/or aortic aneurysm. There- fore, it is necessary to consider anesthetic management of complicated aortic surgery of CoA patient

Methods

This is a retrospective study of six pa- tients with CoA who underwent the CoA repair sur- gery in adulthood from 2005 to 2013.

RESULTS

Pre-operative CoA diameter was 7.8?2.5 mm and pressure gradient was 37±13 mmHg. Four patients had aortic aneurysm. Three patients received lateral thoracotomy and one-lung ventilation; five patients underwent selective cerebral perfusion. As perioperative complications, all two patients with re-CoA surgery had pneumothorax; two of five patients with arch repair surgery had recurrent nerve paralysis; a patient with left subclavian artery ischemia/reperfu- sion, and elevation and flexion of left upper extremity position had left upper extremity paralysis.

CONCLUSIONS

In anesthetic management of adult CoA repair, it is important to understand various surgical approach and corresponding ventilation and extracorporeal circulation methods and possible complications.