Anaesthetic Management of a Down’s Syndrome Patient Acyanotic Congenital Cardiac Anomalies and Hypothyroidism: A Case Report

Abstract

Down Syndrome (DS) is a common chromosomal disorder that is associated with multiple anomalies in different organ systems. Cardiac anomalies are frequently observed in individuals with DS, and as patients with Congenital Heart Disease (CHD) are at an increased risk of developing complications related to anaesthesia during the perioperative and postoperative periods, it is crucial to pay attention to the anaesthetic management of DS patients undergoing corrective surgery for cardiac anomalies. Complete Atrioventricular Septal Defects (CAVSD) are the most prevalent cardiac defects in DS patients, followed by isolated ventricular septal defects, atrial septal defects, patent ductus arteriosus, and tetralogy of Fallot. This case report focuses on the anaesthetic management of a one-year-old female with DS who was diagnosed with a combination of Atrioventricular Septal Defects (AVSDs) and patent ductus arteriosus. Due to the concurrent diagnosis of hypothyroidism, the case required a thorough preanaesthetic examination and meticulous attention to perioperative anaesthetic management, considering factors such as airway difficulty, cervical spine instability, ligament laxity, and susceptibility to infections. The patient underwent cardiac surgery following a standard anaesthetic protocol, and the procedure was well tolerated. After the surgery, she was transferred to the Intensive Care Unit (ICU). The postoperative period was uneventful, and the patient was discharged on the eighth postoperative day