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Intensive care management of neonates with d-transposition of the great arteries and common arterial trunk

Published online by Cambridge University Press:  18 January 2013

Pirouz Shamszad ,
Ryan A. Moore ,
Nancy Ghanayem  and
David S. Cooper
Pirouz Shamszad
Affiliation:
The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio, United States of America
Ryan A. Moore
Affiliation:
The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio, United States of America
Nancy Ghanayem
Affiliation:
The Herma Heart Center, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
David S. Cooper*
Affiliation:
The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio, United States of America
*
Correspondence to: Dr D. S. Cooper, MD, MPH, The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, 3333 Burnet Avenue, MLC 2003, Cincinnati, Ohio 45229, United States of America. Tel: 513 803 1801; Fax: 513 636 3952; E-mail: David.Cooper@cchmc.org
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Abstract

Although mortality rates for patients with d-transposition of the great arteries remain quite low, these patients have a unique circulation that requires careful management in the peri-operative period. Despite the improved mortality for patients with common arterial trunk, the course in the intensive care unit is remarkable for significant morbidity and utilisation of significant resources. Pre-operative patient management focuses on balancing competing circulations, pulmonary and systemic, which exist in parallel rather than in series, as in the normal circulation. Post-operative patient management in both lesions focuses on optimising systemic output, respiratory status, and mitigating the effects of cardiopulmonary bypass. In this article, we review pre- and post-operative intensive care management in neonates with d-transposition of the great arteries and common arterial trunk.

Keywords

D-transposition of the great arteriestruncus arteriosusperi-operative careintensive care22q11 deletion
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 6: A Lifelong Interdisciplinary Approach to Common Arterial Trunk, Transposition of the Great Arteries, and Other Evolving Challenges in Paediatric and Congenital Cardiac Disease , December 2012 , pp. 755 - 760
Copyright
Copyright © Cambridge University Press 2012

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