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Perioperatif Transposition of The Great Arteries

SMF Anestesiologi dan Terapi Pasca Bedah, Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita, Jakarta, Indonesia

Revised: 14 Dec 2020; Accepted: 16 Dec 2020; Available online: 30 Nov 2021; Published: 1 Nov 2021.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Transposition of the great arteries (TGA) merupakan salah satu kelainan jantung kongenital yang kompleks. Pada TGA, terjadi pertukaran sistem arterioventrikular di mana arteri pulmonalis keluar dari ventrikel kiri (LV) dan aorta keluar dari ventrikel kanan (RV). Pertukaran ini menyebabkan perubahan dalam sirkulasi darah, di mana darah yang teroksigenasi mengalir ke paru-paru dan darah yang tidak teroksigenasi mengalir ke sirkulasi sistemik.

TGA memiliki beberapa variasi yang memerlukan perhatian dan tindakan operatif yang berbeda. Secara garis besar, TGA dibagi menjadi congenitally-corrected TGA (cc-TGA) dan dextro-TGA (d-TGA) yang dibagi lagi menjadi dua, yaitu TGA dengan septum interventrikular intak (TGA-IVS) dan TGA dengan defek septum ventrikel (TGA-VSD). Pada cc-TGA, diperlukan tindakan double switch. Pada d-TGA, arterial switch operation (ASO) menjadi prosedur pilihan. Pada TGA-IVS, tingkat mixing menjadi faktor penting yang perlu dijaga. Sementara itu, pada TGA-VSD, hipertensi pulmonal dan gagal jantung lebih sering terjadi. Manajemen anestesi merupakan salah satu hal penting untuk memastikan kelancaran prosedur koreksi.

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Keywords: anestesia; ASO; kongenital; perioperatif; TGA

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