Teeny Tiny Hearts

Diagram of a heart with tricuspid atresia, and...
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Nov 21, 2010

Pediatric cardiac anesthesiologists are pretty much the Gods of anesthesia.  What do I mean by this?  Well, putting kids to sleep and finding IVs and managing their little airways can be tricky.  Now, let’s take that and make it more complex by giving them funky heart anatomy and connections and we’ve got some real tricky anesthesia!

Picture tiny babies, 1-2kg (for the U.S.: 2-4lbs), with teeny tiny hearts…who only have a fightin’ chance in this world with corrective heart surgery.  These tiny hearts are beating away…with some type of pathology that will kill them oftentimes before they reach adulthood.

Sick kids + general anesthesia = possible scary scenario.  Throw in a really good pediatric cardiac anesthesiologist (and pedi heart surgeon)… and that could mean many more years of happy memories!  I’m not sure how these amazing physicians sleep at night (high stress!), but they’re outstanding and certainly have earned my respect!

Some of the cases that I’ve come across:  division of vascular ring; bidirectional Glenn; Fontan; Tetralogy of Fallot repair (extracardiac); hypoplastic aortic arch repair; PDA ligations; modified Blalock-Taussig shunts; AV canal repair; Aortic valve replacement; tricuspid valve repair;  mitral valve repair; Repair of Coarctation.

Some of the pathology I’ve seen: Tetralogy of Fallot, hypoplastic left heart syndrome, coarctation, bicuspid aortic valve, mitral valve prolapse, tricuspid valve prolapse, heterotaxy, unbalanced AV canal, complete vascular ring, patients who were s/p Norwood-Sano, double outlet RV

All I can say is that rotating through pedi hearts for a month was an outstanding experience… one that all adult cardiac anesthesiologists should do.

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