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PROBLEMS ASSOCIATED WITH SURGERY OF THE HEART AND THE GREAT VESSELS:  Anesthetic Problems in Children Undergoing Operations on the Heart and the Great Vessels

FRANCIS M. GREM, M.D.
Arch Surg. 1950;61(2):259-265. doi:10.1001/archsurg.1950.01250020263007.
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Surgical intervention for such congenital anomalies as patent ductus arteriosus, double aortic arch, tricuspid atresia, coarctation of the aorta and tetralogy of Fallot is most apt to be successful when a skilled team exists consisting of cardiologist, surgeons, anesthesiologist, operating room nurses and personnel rendering postoperative nursing care.

Many problems arise from the anesthetic standpoint in the management of patients with these conditions, and it is my intention to report experiences gained from handling 36 patients on whom forty operations Were performed. All offer a challenge but none as great as that offered by the patient undergoing an operation for the relief of a tetralogy of Fallot or of tricuspid atresia.

PREOPERATIVE MANAGEMENT  Every effort is made to bring patients to the operating room in the best possible condition. In most instances it is feasible to delay operation until optimum conditions exist, but this is not invariably the case. Some

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