Spinal anesthesia for open gastrostomy in an infant after stage I Norwood for hypoplastic left heart

• Published in: Annals of cardiac anaesthesia Vol. 25; no. 2; pp. 233 - 235
• Main Authors: Acquaviva, Michael, Hardacker, Doris, Packiasabapathy, Senthil, Burns, Robert
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.04.2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Anesthesia, Spinal; Bupivacaine; Case Report; Complications and side effects; Gastrostomy; General anesthesia; Humans; hypoplastic left heart syndrome; Hypoplastic Left Heart Syndrome - surgery; Infant; infant spinal; Infants; Mortality; norwood; Ostomy; Palliative Care - methods; Pediatric anesthesia; Retrospective Studies; spinal anesthesia; sub-arachnoid block; Treatment Outcome; Gastrostomy; Norwood; sub-arachnoid block; infant spinal; spinal anesthesia; hypoplastic left heart syndrome
• ISSN: 0971-9784; 0974-5181
• DOI: 10.4103/aca.aca_262_20

Infants with hypoplastic left heart are at increased risk of adverse events including mortality when they undergo procedures with general anesthesia in the inter-stage period after stage I Norwood. This is primarily caused by an imbalance between pulmonary and systemic blood flows augmented by decreased function of the single ventricle. These factors can be aggravated by general anesthesia, hence the increased risk. Many of these infants experience feeding dysfunction and require a gastrostomy to optimize nutrition. We report a case of open gastrostomy in an infant with Norwood physiology under spinal anesthesia with an excellent outcome.