Case Report
Ambulatory Anesthesia in an Adult Patient with Corrected Hypoplastic Left Heart Syndrome
Table 1
Preoperative evaluation.
| PMH | Hypoplastic left heart | Sick sinus with pacemaker | Hypertension | Cirrhosis | Lung arteriovenous malformations |
| PSH | Norwood (at birth) | Glen (at 4 m) | Fontan (at 5 y) | Cholecystectomy | Tonsillectomy | Wrist surgery | Esophagogastroduodenoscopy | Cardiac cath |
| Meds | Spironolactone | Digoxin | Atenolol | Aspirin | Hydrochlorothiazide | Losartan | Pantoprazole | Potassium chloride |
| Labs | Hemoglobin 17.5, platelets of 100 [nadir 50] | AST 49, ALT 70 | INR of 1.3 | Na 123, K 3.7, Cr 0.73, HCO3 23 | Albumin 4.8, total protein 7.2 |
| EKG | Heart rate 79 bpm, atrial-paced with 1o AV block, right access deviation, | incomplete right bundle branch block, right ventricular hypertrophy, | ST depression in precordial leads with T wave inversion (nonacute) |
| Echo | Grossly adequate myocardial function, no Fontan obstruction, unobstructed atrial septal defect, mild aortic regurgitation |
| Cardiac Cath | Patent superior vena cava to right pulmonary artery conduit with a saturation of 88%, mean pressure of 14 mmHg, | inferior vena cava to left pulmonary artery conduit with a saturation of 85%, mean pressure of 14 mmHg |
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