Alisha management of surgical in kuala lumpur

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1. MDT Case Presentation

2. Patient Particulars Name: NUR ALISHA BINTI SHAFEEQ AHAMED MRN: 432987 Age: 4 year 9 month Gender: Female Dx: TOF PA MAPCAS s/p RMBTS, s/p LMBTS Height: 102cm Weight: 15.6kg BSA: 0.62m 2 BMI: 15 kg/m 2

3. Clinical history FTSVD BW 2.38kg at Gleneagles Hosp. Antenatally diagnosed with PAVSD RMBTS (February 2019) LMBTS (September 2019) MDT: Moderately cyanosed, 2 MAPCAS both stenosed distally, inadequate lung segments supplied (missing right middle, left lingular and left upper posterior lobes), limiting conduit without unifoc is very high-risk option  for conservative care

4. Current status Well, Alert, comfortable, cyanosed Clinical Examination Blood pressure: 110/60 mmHg,Pulse rate: 100 beats/min. SPO2: 80% in room air Chest: B/L normal Vesicular Breath sound, No added sounds Cardiovascular system Normal heart sound ejection systolic murmur 3/6 at the ULSE radiating to carotids Abdomen Soft, non tender, no organomegaly.

5. Current medications Aspirin 60mg once daily

6. Chest X-ray

7. Electrocardiogram

8. Echocardiogram (10/12/2023)

9. Echocardiogram (10/12/2023)

10. Cardiac CT (2023)

11. Cardiac Cath (2023)