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Anesthetic implications for coexisting cardiac capillary hemangioma and multiple coronary artery to pulmonary artery fistulas.

Authors
  • Navas-Blanco, Jose R1
  • Patsias, Iani2
  • Sanders, Joseph A3
  • 1 Department of Anesthesia, Pain Management and Perioperative Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
  • 2 Department of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
  • 3 Department of Anesthesia, Division of Cardiothoracic Anesthesia, Pain Management and Perioperative Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
Type
Published Article
Journal
Saudi Journal of Anaesthesia
Publisher
Medknow Publications
Publication Date
Jan 01, 2018
Volume
12
Issue
3
Pages
482–484
Identifiers
DOI: 10.4103/sja.SJA_11_18
PMID: 30100854
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Abnormalities of the coronary vascular branches and cardiac hemangiomas represent together unusual clinical entities, with an incidence difficult to establish for the former as the vast majority of the patients with these anomalous vascular connections are usually asymptomatic and 2.8% for the latter. Symptomatic patients may develop dyspnea on exertion or chest pain secondary to a "coronary steal" phenomenon as part of the underlying pathophysiology of the disease. The authors report a case of a patient with concomitant cardiac capillary hemangioma with multiple coronary to pulmonary artery fistula connections that was successfully treated with surgical resection of the tumor and ligation of the fistula tracts. A comprehensive and balanced anesthesia management aimed to preserve tight hemodynamic stability to avoid increased myocardial demand and worsening of the coronary steal becomes essential in these patients.

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