Penatalaksanaan Anestesi Pada Total Anomalous Pulmonary Venous Drainage

*Bagus Damar Ririh Wiyatmoko -  Rumah Sakit Pusat Jantung Harap Kita Jakarta, Indonesia
Chairil Gani Koto -  Rumah Sakit Pusat Jantung Harap Kita Jakarta, Indonesia
Published: 1 Jul 2013.
Open Access
Citation Format:
Article Info
Section: Laporan Kasus
Language: ID
Full Text:
In Vol 5, No 2 (2013): Jurnal Anestesiologi Indonesia
Statistics: 292 84
Abstract
Pendahuluan: TAPVD merupakan salah satu CHD yang bersifat sianotik. TAPVDmerupakan anomali vena paru kongenital yang mana tidak ada hubungan antarapembuluh darah paru dan atrium kiri; vena paru terhubung langsung ke atrium kananatau ke vena sistemik (inominata, vena cava superior, Azygus, vena cava inferior atauvena portal) oleh jalur alternatif (vena vertikal). Karena semua darah vena kembali keatrium kanan, sehingga kelangsungan hidup penderita tergantung pada koneksi antaraatrium kiri dan kanan.
Kasus: Anak laki-laki 12 tahun dengan keluhan cepat lelah dan berat badan sulit naik.Ekokardiografi menunjukkan adanya TAPVD supracardiac (ke V.inominata), ASDbesar (pirau kanan ke kiri), TR mild dan PH moderate. Prinsip manajemen anestesidengan mengurangi aliran darah ke paru melalui kontrol ventilasi dan pertimbangkanekstubasi cepat setelah repair. Monitoring dengan CVP, LA pressure dan PA pressuresangat membantu. Hipertensi pulmonal perioperatif ditangani dengan hiperventilasi,oksigen 100%, alkalinisasi, sedasi dalam dan pelumpuh otot.
Keywords
total anomalous pulmonary venous drainage; penyakit jantung bawaan; anestesi

Article Metrics:

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