Congenital Cardiac Anesthesia Society - Congenital Cardiac Anesthesia Society

A 6-month-old infant is undergoing a full repair for Tetralogy of Fallot. The patient separates from cardiopulmonary bypass (CPB) on milrinone 0.05 mcg/kg/min, dexmedetomidine 0.5 mcg/kg/h and morphine 0.025 mg/kg/h. The surgeon measures a right ventricular (RV)-to-aortic pressure ratio of 0.5, and right ventricular outflow tract (RVOT) gradient of 30 mmHg. Ten minutes later the vital signs are: BP 50/38, HR 167 bpm in sinus rhythm, SpO2 100%, with adequate anesthetic depth. The transesophageal echocardiogram (TEE) is now showing hyperdynamic right ventricular systolic function with subvalvar obstruction. In addition to volume administration, what is the recommended next step in management?

A. Return to CPB for reintervention
B. Administer calcium
C. Bolus esmolol and begin an infusion

Answer Question

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Dr. Dolly D. Hansen, "the Mother of Pediatric Cardiac Anesthesia", devoted her entire career to the life of children with congenital heart disease (CHD).

When Dr. Dolly D. Hansen retired from BCH, she graciously donated funds for an endowed chair at Boston Children's Hospital. Dr. Hansen's wishes were that the funds would be utilized to conduct research, provide education to generations of professionals caring for CHD patients, and to improve the lives of patients with CHD.

It is fitting to honor Dolly's remarkable career and fulfill her wishes by establishing the Dr. Dolly D. Hansen Educational Fund. This Fund is intended to serve the educational mission of the Congenital Cardiac Anesthesia Society.

Click to donate to the Dolly D. Hansen, MD Educational Fund
Click for a list of donors

The CCAS is a group of physician and affiliated providers who care for children and adults receiving anesthesia or sedation for cardiac anomalies. It is affiliated with the Society for Pediatric Anesthesia and holds annual meetings in conjunction with the SPA. Membership in the Slack discussion group is restricted to members of the CCAS or other healthcare providers.

Click here to join the discussion.

If you wish to be added to the discussion, please email [email protected].