Two wrongs make a right: A case report on the anesthetic management of a pediatric patient with congenitally corrected transposition of great arteries

ABSTRACT

@#Congenitally corrected transposition of the great arteries (ccTGA) or ventricular inversion, is a rare form of congenital heart disease (CHO) representing approximately 0.5% of all CHO. It is characterized by atrioventricular and ventriculoarterial discordance, in which the atria are connected to the opposite ventricle, and the ventricles are connected to the incorrect great artery. The defect is termed "corrected" because of the physiologic flow of blood through the body despite the malformation. ccTGA can be associated with other cardiac anomalies like ventricular septa! defect (VSO), pulmonary outflow tract (LVOT) obstruction, tricuspid valve lesions, and coronary artery anomalies. This paper aims to discuss the anesthetic management unique to patients with ccTGA in which the ultimate goal is to prevent hemodynamic instability that could potentially lead to cardiac failure. Here, we report the anesthetic management of a 6 year old child with ccTGA with mild tricuspid regurgitation who underwent plastic repair of cleft lip under general endotracheal tube anesthesia (inhalational). With use of balanced anesthesia to produce minimal to no cardiovascular effects, the operation concluded successfully.