Anestesi Kaudal pada Neonatus dengan Suspek Sindrom Down dan Hipotiroid Kongenital yang dilakukan Tindakan Anoplasi

Abstract

Grown-up congenital heart disease (GUCH) is the highest incidence of heart diseases with a 10% incidence of congenital heart defects in adults is acyanotic Atrial Septal Defect (ASD). ASD optimal therapy remains controversial. Surgery is recommended in middle age and old age patients with significant left to right shunting. The most common comorbid in a young adulthood congenital defect is unstable hemodynamic, pulmonary hypertension, arrhythmia, cardiovascular diseases andrespiratory infections. Female patient 29 years old with atrial septal defect and pulmonary hypertension, Right ventricle (RV) and Left ventricle (LV) Smallish conducted ASD closure surgery. Preoperative preparation includes anamnesis, physical examination and investigation. The main pathological changes are an increase in pulmonary vascular resistance and secondary changes in increased blood flow from left to right shortcuts. The perioperative problem in this patients is small size of the left heart atrium and ventricle which giving result of unstable hemodynamic like arrhythmia and pulmonary hypertension when atrial defect closure done. Under these conditions, given the hemodynamic was support with medication (nitroglycerin, milrinone, norepinephrine, adrenaline) and reconstruction of Patent Foramen Ovale (PFO), resulting in stable hemodynamic during surgery and treatment in the Intensive Care Unit (ICU