Congenital Cardiac Anesthesia Society
A Section of the the Society for Pediatric Anesthesia

Congenital Cardiac Anesthesia Society

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Question of the Week 384

Authors: Destiny F. Chau, MD - Arkansas Children’s Hospital/University of Arkansas for Medical Sciences, Little Rock, AR and Meera Gangadharan, MD – McGovern Medical School, UTHealth, Houston


A 17-year-old male adolescent with a history of hypoplastic left heart syndrome and Fontan palliation presents for diagnostic cardiac catheterization due to cyanosis with baseline saturations of 87% on room air. A transthoracic echocardiogram shows adequate right ventricular systolic function with mild tricuspid regurgitation and normal neo-aortic valve function. The hemodynamic catheterization reveals Fontan pressures of 13 mmHg, transpulmonary gradient of 4 mmHg, right ventricular end diastolic pressure of 9 mmHg, and an open Fontan pathway with device occlusion of the fenestration. A focused transthoracic echocardiography saline microbubble contrast study is performed with injections into the right pulmonary artery (PA) and produced the findings below.


L Panel


R Panel Figure 1. Apical 4 chamber view by transthoracic echocardiogram with saline contrast study. Before (L panel) and after (R panel) saline injection into the right pulmonary artery (RPA). (Image source credit: authors).


What is the MOST LIKELY etiology of decreased oxygen saturation?

Correct! Wrong!

Question of the Week 384

Poll of the Month

January 2023
At your institution, are intubated cardiac patients routinely transported to and from procedural locations on a transport ventilator?
View Results
Total Answers 154
Total Votes 154

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CCAS 2023 Annual Meeting
March 30, 2023
JW Marriott
Austin, TX

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