Perioperative Management of Patients with Ventricular Septal Defect, Severe Tricuspid Regurgitation and Gerbode Defects

<p>Ventricular Septal Defect (VSD) is a congenital heart disease that causes the connection between left and right ventricles called Gerbode defect. Manifestation of defect damage to opening tricuspid valve caused regurgitation valve. Delay in diagnosis intervention will affect pre-operative nutritional status malnutrition.</p><p>We reported boy aged 2 months, weighing 3100 grams with biliary atresia followed by VSD, severe TR, who undergo Kasai procedure. Preoperative physical examination showed GCS E4V5M6, SpO2 100%. The skin gets icteric all over body conjunctiva. cardiovascular system has regular I-II sound, 2/3 mid clavicular S noise as high ICS pansystolic murmur. abdomen slight distended. Child pug score 8. Hemoglobin value 6.7gr%, hematocrite 37%, APTT 44.8 seconds, SGOT 443 U / L, SGPT 560 total bilirubin 23.89 mg dl, direct 13.92 indirect 9.97 dl.</p><p>The goal anesthesia Severe Tricuspid Regurgitation (TR) preventing excessive ventilation avoid pulmonary hypertension. choice anesthetic agent based on patient's physiology balancing systemic blood flow. Perioperative management cases TR following report describes importance understanding pathophysiology VSD defects obtain good outcome.</p><p>Perioperative patients, requires more supervision, especially minimize increase PVR, maintain vascular resistance (SVR) prevent hypertension.</p>