• S. Afr. Med. J. · Dec 2006

    Case Reports

    Regional cerebral oxygenation monitoring--intraoperative management in a patient with severe left ventricular dysfunction.

    • Richard J Ing, Stephanie Fischer, Steve Shipton, Rebecca Gray, Jenny Thomas, and John Hewitson.
    • Department of Anaesthesiology, Red Cross War Memorial Children's Hospital and University of Cape Town, South Africa. richzing@yahoo.com
    • S. Afr. Med. J. 2006 Dec 1;96(12):1266-8.

    AbstractIntraoperative near-infrared spectroscopy cerebral oxygenation monitoring assists intraoperative decision-making in environments without extracorporeal membrane oxygenation (ECMO), left ventricular assist device (LVAD) or access to cardiac transplantation. We report a case of an anomalous left coronary artery arising from the pulmonary artery (ALCAPA), undergoing cardiac surgery. A 4-month-old infant presented in extremis with cardiac failure. We discuss the pathophysiology and challenging intraoperative management of ALCAPA with extensive ischaemia and myocardial infarction.

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