We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Preoperative management of the neonate with critical aortic valvar stenosis.
- Authors
Affolter, Jeremy T.; Ghanayem, Nancy S.
- 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.
- Subjects
AORTIC stenosis treatment; CARDIOGENIC shock; CARDIAC catheterization; VENTRICULAR outflow obstruction; PEDIATRIC intensive care; PROSTAGLANDINS; PERFUSION; THERAPEUTICS
- Publication
Cardiology in the Young, 2014, Vol 24, Issue 6, p1111
- ISSN
1047-9511
- Publication type
Article
- DOI
10.1017/S1047951114002029