00561 Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age

Name of the Procedure:

Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age.

Summary

This procedure involves administering anesthesia to infants younger than 1 year who are undergoing surgical procedures on the heart, pericardial sac, or major blood vessels in the chest. An oxygenator pump is used during the surgery to support the infant's breathing and circulation.

Purpose

This form of anesthesia is crucial for ensuring the infant remains pain-free and immobile during complex heart surgeries. The use of a pump oxygenator aids in maintaining oxygenation and circulation while surgeons operate on the heart or associated structures.

Indications

• Congenital heart defects requiring surgical correction
• Inflammatory or infectious conditions of the pericardial sac
• Aneurysms or abnormalities in the great vessels of the chest

Preparation

• Fasting typically from 4-6 hours before the procedure.
• Pre-operative assessment, including blood tests, echocardiograms, and possibly chest X-rays.
• Adjustment or cessation of certain medications as directed by the healthcare provider.

Procedure Description

1. Pre-Anesthesia Evaluation: Review of medical history, physical examination, and blood tests.
2. Induction of Anesthesia: Administering anesthesia via intravenous (IV) line or inhalation, ensuring the infant is asleep and pain-free.
3. Intubation and Mechanical Ventilation: Inserting a breathing tube to assist with breathing.
4. Connection to Pump Oxygenator: During surgery, a machine (pump oxygenator) takes over the function of the heart and lungs to maintain blood flow and oxygen levels.
5. Continuous Monitoring: Vital signs and oxygen levels are closely monitored throughout the procedure.

Duration

The procedure duration varies depending on the complexity of the surgery but generally ranges from 3 to 6 hours.

Setting

Performed in a hospital operating room, specifically in a cardiac surgery unit.

Personnel

• Pediatric cardiac surgeon
• Pediatric anesthesiologist
• Surgical nurses
• Perfusionist (operates the pump oxygenator)
• Operating room technicians

Risks and Complications

• Possible allergic reactions to anesthesia
• Infection at the IV or surgical site
• Bleeding or blood clots
• Cardiac or respiratory complications
• Rarely, brain injury due to lack of oxygen

Benefits

• Pain-free surgery for complex congenital heart conditions
• Corrective intervention to improve heart function and overall health
• Lifesaving operation with potential for significant long-term benefits

Recovery

• Close monitoring in a pediatric intensive care unit (PICU) post-surgery.
• Pain management and administration of medications as needed.
• Gradual reintroduction of fluids and feedings.
• Follow-up appointments for wound care and assessment of heart function.

Alternatives

• In some cases, medication management or less invasive procedures may be considered, but they might not be as effective.
• Risks and benefits need to be carefully weighed against other potential interventions by the healthcare team.

Patient Experience

The infant will be under general anesthesia and will not feel pain during the procedure. Post-operatively, they may experience discomfort and will receive appropriate pain management. Parental support and comfort are important during recovery.