Mubashir Z Khan, MBBS, FCPS King Faisal Specialist Hospital Riyadh
2 weeks baby
2.9 kg
Post-natal collapse
PGE started and stabilized
COA and Hypoplastic Aortic Arch
PDA
LV good size and Function
Posteriorly Deviated septum to LVOT
Sub-pulmonary VSD (small-modearte)
COA and Arch augmentation with glutaraldehyde treated autologous pericardium
VSD closure through the pulmonary artery
Anomalous LAD from RCA crossing RVOT
Open chest
Stable hemodynamics
Transfer to ward
Feeding issues
Prolonged hospital stay for feeding issues
Condition deteriorated 1 month after surgery
Mottled,Cold,dyspneic
Readmitted to CSICU and intubated
Severe sub aortic obstruction with gradient 46 mmHg
LVEDP 38mmHg
No arch gradient
Take down of VSD patch
DKS
Rt BT shunt with 4mm Gortex tube graft
Turbulent initial course
Chest closed 1 week later
Failed extubation
Metabolic acidosis with weaning
ď ˝
Patient continued to fail extubation many times with metabolic acidosis during weaning
LVEDP 26mmHg
Gradient from LV to aorta 45mmHg
Tiny VSD seen
VSD enlargement
Augmentation of DKS-arch anastomosis
ECMO
ECMO weaning 3 days later
Chest closed 1 week post-op
Complete heart block requiring pacemaker insertion
Tracheostomy
Progressive worsening of condition
Metabolic acidosis
Sepsis
Cardiac arrest