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ST Segment–Elevation Myocardial Ischemia After Arterial Switch Operation due to Pericardial Drain Placement

A Case Report

Bhat, Imran, MD, DM; Kajal, Kamal, MD; Gourav, Krishna Parsad, MD; Damodaran, Srinath, MD; Munirathinam, Ganesh Kumar, MD; Ganesan, Rajarajan, MD, DM

doi: 10.1213/XAA.0000000000000925
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Myocardial ischemia postarterial switch operation has been reported extensively in the literature and has been almost exclusively ascribed to issues related to coronary artery translocation. Here, we report a case of a 5-week-old child with D-transposition of the great arteries who underwent an arterial switch operation and developed myocardial ischemia after pericardial drain placement, as evidenced by significant ST segment elevation and abnormal regional cardiac wall motion. The ST segment and cardiac wall motion improved once the drain was withdrawn from the pericardium and placed in the retrosternal space. Few reports in the literature describe this complication, particularly in pediatric patients.

From the Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Accepted for publication October 1, 2018.

Funding: None.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal’s website.

Address correspondence to Kamal Kajal, MD, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India 160012. Address e-mail to kamal.kajal@gmail.com

© 2019 International Anesthesia Research Society
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