Anesthesia management experience in transcatheter ultrasound-guided percutaneous interventional treatment of congenital heart disease with a mobile operating platform_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIE Chunmei ¹ , ZHU Da ² , WANG Shouzheng ^2,3 , FENG Yaling ⁴ , LU Jiang ⁵ , GAO Jianbin ² , YANG Ke ¹ , LI Xinghuan ¹ , ZHANG Deyuan ⁶ ,  PAN Xiangbin ^2,3

1. Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
2. Department of Structure Heart Center, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
3. Department of Structure Heart Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China;
4. Department of Operate Security, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
5. Medical Department, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
6. Xianjian Technology Company, Shenzhen, 518109, Guangdong, P. R. China;

Corresponding author：

PAN Xiangbin, Email: panxiangbin@fuwaihospital.org

Keywords：

Transthoracic echocardiography; mobile operating platform; congenital heart diseases; interventional surgery; anesthesia management

DOI：

10.7507/1007-4848.202309048

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Objective To investigate the anesthesia management of transcatheter ultrasound-guided percutaneous interventional therapy for pediatric patients with congenital heart disease at a mobile surgical platform. Methods From March to July 2023, 13 patients in remote areas underwent interventional surgery on the mobile truck operating platform. The patients undergoing general anesthesia using non-tracheal intubation were collected. Results Finally, 8 patients received monitored anesthesia care (MAC) with local anesthesia-assisted sedation and analgesia drugs under the supervision of anesthesiologists (general anesthesia using non-tracheal intubation), due to the patients having difficulty cooperating with the surgery (young age, nervous mood, and crying), including 5 males and 3 females with an average age of 6.95±3.29 years and an average weight of 19.50±6.04 kg. There were 6 patients diagnosed with atrial septal defect, 1 patient with residual shunt after patent ductus arteriosus ligation, and 1 patient with severe pulmonary stenosis by transthoracic ultrasonography. The surgical process was smooth, analgesia was perfect, anesthesia and surgical effect were satisfactory, postoperative recovery was satisfactory, and there were no surgical or anesthesia complications. The anesthesia time was 41.53±8.62 min, the operation time was 39.88±8.52 min, and the recovery time was 41.50±14.56 min. Conclusion Transthoracic ultrasound-guided interventional surgery is a minimally invasive approach for congenital heart disease, offering the advantages of zero radiation exposure. Non-tracheal general anesthesia preserved spontaneous breathing can be safely and effectively administered to pediatric patients who cannot cooperate in mobile operating platform.

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4.	潘湘斌, 胡盛寿, 欧阳文斌, 等. 单纯超声引导下经皮肺动脉瓣球囊成形术的应用研究. 中华小儿外科杂志, 2015, 36(4): 286-288.
5.	王首正, 刘垚, 王珊, 等. 单纯超声引导下经股静脉行动脉导管封堵术的应用研究. 中华医学杂志, 2015, 95(27): 2183-2185.
6.	Xie CM, Yao YT. Anesthesia management for pediatrics with congenital heart diseases who undergo cardiac catheterization in China. J Interv Cardiol. 2021, 13(5): 323-331.
7.	刘友坦, 郭荣鑫, 陈向东, 等. 老年患者手术室外麻醉/镇静专家共识. 临床麻醉学杂志, 2023, 39(6): 659-662.
8.	王龙飞, 周雪飞, 张勇华, 等. (支)气管镜诊疗镇静麻醉的国内外指南或专家共识比较. 浙江医学, 2023, 45(13): 1438-1442.
9.	Krmpotic K, Rieder MJ, Rosen D. Recommendations for procedural sedation in infants, children, and adolescents. Paediatr Child Health, 2021, 26(2): 128-129.
10.	Maddirala S, Theagrajan A. Non-operating room anesthesia in children. Indian J Anaesth, 2019, 63(9): 754-762.
11.	郭曲练, 程智刚, 胡浩. 麻醉后监测治疗专家共识. 临床麻醉学杂志, 2021, 31(1): 89-94.
12.	尹随, 李樊, 邓豫, 等. 非气管插管麻醉在胸腔镜肺叶切除术中的应用对比研究. 中国胸心血管外科临床杂志, 2019, 25(1): 57-62.

1. Wagdi P, Ritter M. Patient radiation dose during percutaneous interventional closure of interatrial communications. J Cardiol, 2009, 53(3): 368-373.
2. Pan XB, Ou-Yang WB, Pang KJ, et al. Percutaneous closure of atrial septal defects under transthoracic echocardiography guidance without fluoroscopy or intubation in children. J Interv Cardiol, 2015, 28(4): 390-395.
3. 潘湘斌, 李守军, 胡盛寿, 等. 经胸超声心动图引导房间隔缺损封堵术的可行性. 中华心血管病杂志, 2014, 442(9): 744-747.
4. 潘湘斌, 胡盛寿, 欧阳文斌, 等. 单纯超声引导下经皮肺动脉瓣球囊成形术的应用研究. 中华小儿外科杂志, 2015, 36(4): 286-288.
5. 王首正, 刘垚, 王珊, 等. 单纯超声引导下经股静脉行动脉导管封堵术的应用研究. 中华医学杂志, 2015, 95(27): 2183-2185.
6. Xie CM, Yao YT. Anesthesia management for pediatrics with congenital heart diseases who undergo cardiac catheterization in China. J Interv Cardiol. 2021, 13(5): 323-331.
7. 刘友坦, 郭荣鑫, 陈向东, 等. 老年患者手术室外麻醉/镇静专家共识. 临床麻醉学杂志, 2023, 39(6): 659-662.
8. 王龙飞, 周雪飞, 张勇华, 等. (支)气管镜诊疗镇静麻醉的国内外指南或专家共识比较. 浙江医学, 2023, 45(13): 1438-1442.
9. Krmpotic K, Rieder MJ, Rosen D. Recommendations for procedural sedation in infants, children, and adolescents. Paediatr Child Health, 2021, 26(2): 128-129.
10. Maddirala S, Theagrajan A. Non-operating room anesthesia in children. Indian J Anaesth, 2019, 63(9): 754-762.
11. 郭曲练, 程智刚, 胡浩. 麻醉后监测治疗专家共识. 临床麻醉学杂志, 2021, 31(1): 89-94.
12. 尹随, 李樊, 邓豫, 等. 非气管插管麻醉在胸腔镜肺叶切除术中的应用对比研究. 中国胸心血管外科临床杂志, 2019, 25(1): 57-62.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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