[Anesthetic management for repair of Ebstein's anomaly with WPW syndrome]

Area of Science:

• Cardiology
• Anesthesiology
• Congenital Heart Disease

Background:

• Ebstein's anomaly is a rare congenital tricuspid valve malformation.
• It is frequently associated with Wolff-Parkinson-White (WPW) syndrome.
• Anesthetic management presents challenges due to potential decreased cardiac output, cyanosis, and arrhythmias.

Purpose of the Study:

• To describe the perioperative management of patients with Ebstein's anomaly and WPW syndrome.
• To highlight successful anesthetic strategies for tricuspid valve repair and accessory pathway ablation.

Main Methods:

• Case series of three patients (adult male, infant, child) with Ebstein's anomaly and WPW syndrome.
• Anesthetic management involved fentanyl, sevoflurane, and midazolam.
• Transesophageal echocardiography used for evaluation.

Main Results:

• Successful perioperative anesthetic management was achieved in all three cases.
• Tricuspid valve valvuloplasty and accessory pathway ablation were accomplished.
• No major complications were reported during the perioperative period.

Conclusions:

• A combination of fentanyl, sevoflurane, and midazolam is effective for anesthesia in these patients.
• Perioperative arrhythmia management is crucial.
• Transesophageal echocardiography is essential for assessing tricuspid regurgitation.