The Open Access Journal of Science and Technology

Abstract

Ventriculopleural Shunt Surgery in A Patient with Multiple Skeletal and Neuro developmental Anomalies:A True Perioperative Challenge

Author(s): Ashish K. Khanna, Alaa Abd-Elsayed, Ehab Farag, Daniel John Doyle1 and Wael Ali SakrEsa

Introduction:Ventriculopleuralshuntplacementfordecompressionofhydrocephalousisanuncommonprocedure.The usualindicationsareadhesions,infection,thrombosisorobliterationofthemorecommonlydoneventriculoperitonealshuntoran anatomicalnon-availabilityoftheperitoneum.Wepresentaclinicalcaseofapatientwithcongenitalhydrocephalouscomplicated bymultipleskeletalandneurodevelopmentalanomalieswhopresentedforthoracoscopicplacementofaventriculopleuralshunt. Theanestheticchallengesandperioperativemanagementconstitutedacomplexmulti-disciplinarychallenge.Case presentation: We present a clinical case of a 42 years old woman with congenital hydrocephalous complicated by multiple skeletal and neurodevelopmentalanomalieswhopresentedforthoracoscopicplacementofaventriculopleuralshunt.Someoftheperioperative concernsincludedinitiationandmaintenanceofone-lungventilationinapatientwithshortstature,dysmorphicskeletalfeatures, severe kyphoscoliosis, restrictive underlying lung disease and multiple neurodevelopmental midline defects. Conclusion: Our presentation highlights the special challenges in this patient based on the need for lung collapse in a severely short statured individualwithadysmorphicseverelykyphoscolioticthoraciccavityalongwithunderlyingrestrictivelungdiseaseandbackground neurodevelopmentalmidlinedefects.

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