![]() ![]() The subjects were consecutive VSD patients less than 1 year of age who underwent cardiac catheterization between May 2016 and August 2021 at Aichi Children’s Health and Medical Center. This was a single-center, retrospective, observational study. The ultimate goal of this study was to clarify pitfalls when using the parameters measured under GA for judgment regarding the surgical indications and perioperative management. those measured under GA, and to investigate the effects of each sedation method on the hemodynamic parameters. ![]() The purpose of this study was to compare hemodynamic parameters in VSD patients measured during cardiac catheterization under MAC vs. Therefore, it was possible to compare the results of cardiac catheterizations performed under different sedation methods. However, since 2017, when anesthesiologists have been in charge of sedation, cardiac catheterization has been performed under GA in all cases. In Aichi Children’s Health and Medical Center, cardiac catheterization was conventionally performed under MAC by pediatric cardiologists. In addition, there is no report describing which sedation method should be used to measure indexes such as Qp/Qs and pulmonary vascular resistance index (PVRI), to determine the surgical indications for CHD with left-to-right shunt. Although ventilation methods and anesthetics can affect the hemodynamics of CHD, only a few reports have discussed how the hemodynamic parameters used to determine surgical indications are affected by sedation methods. In addition, a consensus statement by the Society for Cardiovascular Angiography and Interventions (SCAI), the Society for Pediatric Anesthesia (SPA) and the Congenital Cardiac Anesthesia Society (CCAS) states that there is no specific sedation method recommended for all CHD. Pediatric cardiac catheterization can be performed under sedation and intravenous anesthesia without artificial ventilation (monitored anesthesia care: MAC), or under general anesthesia (GA) with artificial ventilation. ![]() Cardiac catheterization is an important examination for understanding the hemodynamics of CHD with left-to-right shunts and deciding the therapeutic strategy. Among them, CHD with left-to-right shunts, such as ventricular septal defect (VSD), are common, with some of them requiring surgical treatment. In particular, when using pulmonary artery pressure and pulmonary vascular resistance measured under GA for judgment regarding the surgical indications or perioperative management, consideration should be given to the fact that these parameters might be lower compared to those measured under MAC.Ĭongenital heart diseases (CHD) have great impacts on life prognosis and are frequently found in more than 1% of newborns. Conclusions: Cardiac catheterization under GA in VSD patients results in different hemodynamic parameters compared to that under MAC. There were no significant differences in pulmonary blood flow index, systemic blood flow index, and pulmonary/systemic blood flow ratio between the two groups. Pulmonary vascular resistance index ( p < 0.01) and systemic vascular resistance index ( p < 0.01) were also significantly lower in the GA group than the MAC group. Mean pulmonary artery pressure ( p < 0.05) and systemic blood pressure ( p < 0.01) were lower in the GA group. Results: In the GA group, arterial blood pH and arterial partial pressure of oxygen were significantly higher ( p < 0.01), whereas arterial partial pressure of carbon dioxide was significantly lower than in the MAC group ( p < 0.01). Methods: This study retrospectively evaluated consecutive patients with ventricular septal defect (VSD) below 1 year of age who underwent cardiac catheterization at Aichi Children’s Health and Medical Center, who were divided into age- and VSD diameter-matched general anesthesia (GA) and monitored anesthesia care (MAC) under the natural airway groups ( n = 40 each), for comparison of hemodynamic parameters. ![]() The purpose of this study was to investigate the effects of two different sedation methods on the hemodynamic parameters. In congenital heart diseases with intracardiac shunts, hemodynamic parameters are prone to change depending on the ventilation conditions and anesthetics, although few studies have examined these effects. Abstract Background: There is no gold standard sedation method for pediatric cardiac catheterization. ![]()
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