[Compression of the graft during the corrective surgery for scoliosis in a patient who has undergone a Rastelli's operation: a case study].
A 14 year-old male who had undergone Rastelli's operation for the tetralogy of Fallot had general anesthesia for the corrective spinal instrumentation and posterior fusion. The patient also suffered from the complication of Klippel-Feil syndrome. During the operation, right ventricular pressure gradually increased from 34 mmHg to 60 mmHg and systolic blood pressure decreased from 110 mg to 80 mmHg when the maneuver to correct spinal deformity was done. The hemodynamics returned to its former level after the maneuver was resumed. This change was presumably attributed to the fact that the external conduit was compressed by the sternum and vertebral bodies. In order to prevent this hazardous incidence, it is crucial to understand both the three-dimensional configuration of the thoracic structure and the influence of spinal correction on it. In the prone positioned patients with scoliosis, especially lordoscoliosis, compression or dysfunction of the artificial valve might occur and we have to be aware of the possibility of the compression during general anesthesia and after corrective surgery.