Anesthesia management experience in transcatheter ultrasound-guided percutaneous interventional treatment of congenital heart disease at a mobile operating platform_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIE Chunmei ¹ , ZHU Da ² , WANG Shouzheng ^2,3 , FENG Yaling ⁴ , LU Jiang ⁵ , GAO Jianbin ² , YANG Ke ¹ , LI Xinghuan ¹ , ZHANG Deyuan ⁶ ,  PAN Xiangbin ^2,3

1. Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
2. Department of Structure Heart Center, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
3. Department of Structure Heart Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China;
4. Department of Operate Security, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
5. Medical Department, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, P. R. China;
6. Xianjian Technology Company, Shenzhen, 518109, Guangdong, P. R. China;

Corresponding?author：

PAN Xiangbin, Email: panxiangbin@fuwaihospital.org

Keywords：

Transthoracic echocardiography; mobile operating platform; congenital heart diseases; interventional surgery; anesthesia management

DOI：

10.7507/1007-4848.202309048

Video：

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Objective To explore the anesthesia management experience in the interventional treatment of pediatric congenital heart diseases (CHD) percutaneously guided by transthoracic echocardiography (TTE) on a mobile operating platform. Methods From March to July 2023, a total of 13 patients from remote areas underwent interventional treatment for CHD on the mobile operating platform of Fuwai Yunnan Cardiovascular Hospital. Patients who received non-tracheal intubation general anesthesia were retrospectively included. Results Eight children who had difficulty cooperating with the surgery (due to young age, emotional tension, crying) received monitored anesthesia care with local anesthesia supplemented by sedative and analgesic drugs while maintaining spontaneous breathing under the monitoring and management of an anesthesiologist (i.e., non-tracheal intubation general anesthesia). Among them, there were 5 males and 3 females, with an age of (6.95±3.29) years and a body weight of (19.50±6.04) kg. Through transthoracic echocardiography, they were diagnosed with atrial septal defect (6 patients), residual shunt after patent ductus arteriosus ligation (1 patient), and severe pulmonary valve stenosis (1 patient). The surgery proceeded smoothly, with satisfactory anesthesia and surgical effects, complete analgesia, and satisfactory postoperative recovery. There was 1 patient of body movement and 1 patient of respiratory depression during the operation, and both patients completed the surgery successfully after treatment. All children had no serious surgery- and anesthesia-related complications. The anesthesia time was 40.5 (34.5, 47.5) min, the surgery time was 39.0 (33.0, 45.5) min, and the recovery time was 43.0 (28.0, 52.5) min Conclusion Interventional surgery for CHD guided by TTE at a mobile platform is a minimally invasive approach without radiation damage. Non-tracheal intubation general anesthesia with spontaneous breathing can be safely and effectively implemented in children who cannot cooperate.

Citation： XIE Chunmei, ZHU Da, WANG Shouzheng, FENG Yaling, LU Jiang, GAO Jianbin, YANG Ke, LI Xinghuan, ZHANG Deyuan, PAN Xiangbin. Anesthesia management experience in transcatheter ultrasound-guided percutaneous interventional treatment of congenital heart disease at a mobile operating platform. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(10): 1467-1472. doi: 10.7507/1007-4848.202309048 Copy

1.	Wagdi P, Ritter M. Patient radiation dose during percutaneous interventional closure of interatrial communications. J Cardiol, 2009, 53(3): 368-373.
2.	Pan XB, Ou-Yang WB, Pang KJ, et al. Percutaneous closure of atrial septal defects under transthoracic echocardiography guidance without fluoroscopy or intubation in children. J Interv Cardiol, 2015, 28(4): 390-395.
3.	潘湘斌, 李守軍, 胡盛壽, 等. 經胸超聲心動圖引導房間隔缺損封堵術的可行性. 中華心血管病雜志, 2014, 442(9): 744-747.Pan XB, Li SJ, Hu SS, et al. Feasibility of transcatheter closure of atrial septal defect under the guidance of transthoracic echocardiography. Chin J Cardiol, 2014, 442(9): 744-747.
4.	潘湘斌, 胡盛壽, 歐陽文斌, 等. 單純超聲引導下經皮肺動脈瓣球囊成形術的應用研究. 中華小兒外科雜志, 2015, 36(4): 286-288.Pan XB, Hu SS, Ouyang WB, et al. Application of percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance. Chin J Pediatr Surg, 2015, 36(4): 286-288.
5.	王首正, 劉垚, 王珊, 等. 單純超聲引導下經股靜脈行動脈導管封堵術的應用研究. 中華醫學雜志, 2015, 95(27): 2183-2185.Wang SZ, Liu Y, Wang S, et al. Application research of percutaneous patent ductus arteriosus closure by femoral vein approach under echocardiography guidance. Natl Med J China, 2015, 95(27): 2183-2185.
6.	Xie CM, Yao YT. Anesthesia management for pediatrics with congenital heart diseases who undergo cardiac catheterization in China. J Interv Cardiol. 2021, 13(5): 323-331.
7.	劉友坦, 郭榮鑫, 陳向東, 等. 老年患者手術室外麻醉/鎮靜專家共識. 臨床麻醉學雜志, 2023, 39(6): 659-662.Liu YT, Guo RX, Chen XD, et al. Expert consensus on anesthesia/general sedation for elderly patients in the operating room. J Clin Anesth, 2023, 39(6): 659-662.
8.	王龍飛, 周雪飛, 張勇華, 等. (支)氣管鏡診療鎮靜麻醉的國內外指南或專家共識比較. 浙江醫學, 2023, 45(13): 1438-1442.Wang LF, Zhou XF, Zhang YH, et al. Comparison of domestic and international guidelines or expert consensuses on sedation and anesthesia for bronchoscopy diagnosis and treatment. Zhejiang Med, 2023, 45(13): 1438-1442.
9.	Krmpotic K, Rieder MJ, Rosen D. Recommendations for procedural sedation in infants, children, and adolescents. Paediatr Child Health, 2021, 26(2): 128-129.
10.	Maddirala S, Theagrajan A. Non-operating room anesthesia in children. Indian J Anaesth, 2019, 63(9): 754-762.
11.	郭曲練, 程智剛, 胡浩. 麻醉后監測治療專家共識. 臨床麻醉學雜志, 2021, 37(1): 89-94.Guo QL, Cheng ZG, Hu H. Expert consensus on post-anesthesia monitoring and treatment. J Clin Anesth, 2021, 37(1): 89-94.
12.	尹隨, 李樊, 鄧豫, 等. 非氣管插管麻醉在胸腔鏡肺葉切除術中的應用對比研究. 中國胸心血管外科臨床雜志, 2019, 25(1): 57-62.Yin S, Li F, Deng Y, et al. Comparative study on the application of non-intubated anesthesia in thoracoscopic lobectomy. Chin J Clin Thorac Cardiovasc Surg, 2019, 25(1): 57-62.

1. Wagdi P, Ritter M. Patient radiation dose during percutaneous interventional closure of interatrial communications. J Cardiol, 2009, 53(3): 368-373.
2. Pan XB, Ou-Yang WB, Pang KJ, et al. Percutaneous closure of atrial septal defects under transthoracic echocardiography guidance without fluoroscopy or intubation in children. J Interv Cardiol, 2015, 28(4): 390-395.
3. 潘湘斌, 李守軍, 胡盛壽, 等. 經胸超聲心動圖引導房間隔缺損封堵術的可行性. 中華心血管病雜志, 2014, 442(9): 744-747.Pan XB, Li SJ, Hu SS, et al. Feasibility of transcatheter closure of atrial septal defect under the guidance of transthoracic echocardiography. Chin J Cardiol, 2014, 442(9): 744-747.
4. 潘湘斌, 胡盛壽, 歐陽文斌, 等. 單純超聲引導下經皮肺動脈瓣球囊成形術的應用研究. 中華小兒外科雜志, 2015, 36(4): 286-288.Pan XB, Hu SS, Ouyang WB, et al. Application of percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance. Chin J Pediatr Surg, 2015, 36(4): 286-288.
5. 王首正, 劉垚, 王珊, 等. 單純超聲引導下經股靜脈行動脈導管封堵術的應用研究. 中華醫學雜志, 2015, 95(27): 2183-2185.Wang SZ, Liu Y, Wang S, et al. Application research of percutaneous patent ductus arteriosus closure by femoral vein approach under echocardiography guidance. Natl Med J China, 2015, 95(27): 2183-2185.
6. Xie CM, Yao YT. Anesthesia management for pediatrics with congenital heart diseases who undergo cardiac catheterization in China. J Interv Cardiol. 2021, 13(5): 323-331.
7. 劉友坦, 郭榮鑫, 陳向東, 等. 老年患者手術室外麻醉/鎮靜專家共識. 臨床麻醉學雜志, 2023, 39(6): 659-662.Liu YT, Guo RX, Chen XD, et al. Expert consensus on anesthesia/general sedation for elderly patients in the operating room. J Clin Anesth, 2023, 39(6): 659-662.
8. 王龍飛, 周雪飛, 張勇華, 等. (支)氣管鏡診療鎮靜麻醉的國內外指南或專家共識比較. 浙江醫學, 2023, 45(13): 1438-1442.Wang LF, Zhou XF, Zhang YH, et al. Comparison of domestic and international guidelines or expert consensuses on sedation and anesthesia for bronchoscopy diagnosis and treatment. Zhejiang Med, 2023, 45(13): 1438-1442.
9. Krmpotic K, Rieder MJ, Rosen D. Recommendations for procedural sedation in infants, children, and adolescents. Paediatr Child Health, 2021, 26(2): 128-129.
10. Maddirala S, Theagrajan A. Non-operating room anesthesia in children. Indian J Anaesth, 2019, 63(9): 754-762.
11. 郭曲練, 程智剛, 胡浩. 麻醉后監測治療專家共識. 臨床麻醉學雜志, 2021, 37(1): 89-94.Guo QL, Cheng ZG, Hu H. Expert consensus on post-anesthesia monitoring and treatment. J Clin Anesth, 2021, 37(1): 89-94.
12. 尹隨, 李樊, 鄧豫, 等. 非氣管插管麻醉在胸腔鏡肺葉切除術中的應用對比研究. 中國胸心血管外科臨床雜志, 2019, 25(1): 57-62.Yin S, Li F, Deng Y, et al. Comparative study on the application of non-intubated anesthesia in thoracoscopic lobectomy. Chin J Clin Thorac Cardiovasc Surg, 2019, 25(1): 57-62.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Anesthesia management experience in transcatheter ultrasound-guided percutaneous interventional treatment of congenital heart disease at a mobile operating platform

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