13 October 2023
: Case report 
Improved Surgical Outcomes in Adults with Congenital Heart Disease and Decompensated Heart Failure: The Role of Perioperative Medical Optimization
Challenging differential diagnosis, Unusual setting of medical care, Congenital defects / diseases
Anton Minaev
1ADE*, Vladimir Podzolkov1CD, Timur Danilov1BC, Mikhail Chiaureli1DE, Bupe Mumba Mwela 2EF, Vera Dontsova1BE
DOI: 10.12659/AJCR.939230
Am J Case Rep 2023; 24:e939230
Table 1. A summary of the preoperative period.
| N | Age/Sex | Initial CHD | Previous procedures | Admission state | Comorbidities | Medication and procedures | Treatment period | Preoperative state |
|---|---|---|---|---|---|---|---|---|
| 1 | 49/m | DORV | DORV repair, cardioversion | LVEF 33%, RVEF 33%, CI 3.2 L/min/m, TR, PR, MR, residual shunts, BNP 440 pg/ml | Atrial flutter, hypothyroidism | ARNI, sotalol, phosphocreatine, diuretics, levosimendan | 2 weeks | LVEF 47%, RVEF 39%, cardiac index 4.6 L/min/m, BNP 214 pg/ml |
| 2 | 45/f | ccTGA | Pacemaker implantation | SVEF 27%, CI 1.8 L/min/m, TR, MR, BNP 1280 pg/ml | – | ARNI, bisoprolol, phosphocreatine, diuretics, levosimendan | 2 months | SVEF 40%, cardiac index 2.8 L/min/m, BNP 110 pg/ml |
| 3 | 32/f | ToF with single right PA | Palliative infundibulectomy, total repair, TV replacement | LVEF 60%, TP dysfunction, PR, FAC RV 26%, Hb 8.0 g/dl, BNP 370 pg/ml | Atrial flutter, iron-deficiency anemia | Cardioversion, ARNI, amiodarone, diuretics, iron | 2 months | Hb 11.8 g/dl, sinus rhythm, RVEF, BNP 160 pg/ml |
| 4 | 49/f | PAPVR | – | LVEF 50%, ASD, TR, BMI 32 kg/m, BNP 215 pg/ml | Atrial fibrillation, hypertension | ARNI, bisoprolol, diuretics | 1,5 weeks | BMI 29 kg/m, BNP 110 pg/ml |
| 5 | 62/m | ASD | – | LVEF 45%, ASD, TR, BMI 28 kg/m, BNP 173 pg/ml | Atrial fibrillation | ARNI, bisoprolol, phosphocreatine, diuretics | 8 days | LVEF 52%, BMI 26 kg/m, BNP 88 pg/ml |
| DORV – double-outlet right ventricle; ccTGA – congenitally corrected transposition of the great arteries; ToF – tetralogy of Fallot; PAPVR – partial anomalous pulmonary veins return; ASD – atrial septal defect; LV – left ventricle; RV – right ventricle; SV – systemic ventricle; EF – ejection fraction; CI – cardiac index; FAC – fractional area change; TR – tricuspid regurgitation; MR – mitral regurgitation; PR – pulmonary regurgitation; ARNI – angiotensin receptor neprilysin inhibitor; BMI – body mass index. | ||||||||