Saving critically ill children due to congenital heart syndrome causing arterial occlusion

Embolism due to heart defect

On April 6, the news from Can Tho Central General Hospital said that the doctors of the Department of Thoracic and Vascular Surgery had successfully operated on a pediatric patient suffering from heart failure. artery occlusion popliteal with congenital heart disease 2-way shunt – syndrome Eisenmenger. A severe disease caused by a structural defect in the heart, in which there is an abnormal flow of blood between the chambers of the heart through the openings, causing lack of oxygen in the body serious.

The patient is continuing to be monitored and treated at the Department of Thoracic Vascular Surgery, Can Tho Central General Hospital Dinh Tuyen

Before that, a male patient NXP (14 years old, living in Bac Lieu province) was admitted to the hospital with fatigue, shortness of breath, pain in his right leg, cold right leg, and no pulse in the right popliteal artery. The results of color echocardiography, vascularity and computed tomography angiography with contrast showed that the patient had complete occlusion of the distal right superficial femoral artery due to thrombosis. In addition, the patient also had a large ventricular septal defect, a 2-way shunt, and very severe pulmonary hypertension of 100 mmHg.

The patient is indicated for emergency surgery to remove thrombus with the diagnosis: acute right popliteal artery occlusion, 2-way shunt ventricular septal defect – Eisenmenger syndrome. Severe condition with high risk of death.

Currently, the patient’s condition is awake, vital signs are stable Dinh Tuyen

The team of Dr. Tran Thanh Binh, Department of Thoracic Vascular Surgery, BS.CK1 Nguyen Van Vinh, Department of Anesthesiology and Resuscitation performed surgery on the patient. The doctors performed exposure of the right common femoral artery, superficial femoral artery, and deep femoral artery and used an instrument to remove many thrombus. Then place a follow-up drain and check the good posterior tibial artery. After more than 70 minutes, the surgery was successful.

At present, the child’s condition is awake, vital signs are stable, incision is dry, tibial pulse is clear, right limb is warm and pink. The patient is continuing to be monitored and treated at the Department of Thoracic Vascular Surgery.

What is Eisenmenger syndrome?

According to BS.CK2 Tran Huynh Dao, Head of Anesthesiology and Resuscitation Department of Can Tho Central General Hospital, Eisenmenger syndrome is usually the result of a structural defect in the heart, in which an abnormal blood flow exists. between the chambers of the heart through holes, creating a mixture of bright red blood, which is rich in oxygen, and dark red, which is poor in oxygen. As a result, the organs in the body cannot meet the required oxygen needs.

Patients with Eisenmenger Syndrome can face many serious complications such as acute hypoxia, brain abscess, embolism, thrombosis, easy bleeding due to thrombocytopenia… to daily life, even life-threatening. In emergency surgery, the risk of complications and operative mortality in patients with pulmonary hypertension and Eisenmenger syndrome is very high.

Surgical team for the patient Dinh Tuyen

Talking more about the emergency case of the above critical pediatric patient, BS.CK2 Pham Thanh Phong, deputy director of Can Tho Central General Hospital, said that with such surgeries, coordination is required to be successful. Synchronous, effective of many specialties: Emergency, cardiology, anesthesia resuscitation, imaging, thoracic vascular surgery…

“Especially in the pathological surgeries with extremely high mortality risk such as Eisenmenger syndrome, pulmonary hypertension, arterial occlusion, it is necessary to have a good team of anesthesia and resuscitation. To ensure that the patient is stable, the surgeon can wholeheartedly perform the surgery successfully,” said Dr. Phong.